Individual provider Active NPI

Miki Allen, AGNP-BC

  • Adult Health Nurse Practitioner
  • High Point, NC
National Provider Identifier
1265140677
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5020246 Issued in NC
Practice address
4050 Piedmont Pkwy
High Point, NC 27265-9458
Phone
(336) 801-7060
NPI assigned
Nov 14, 2022
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5020246 NC
Adult Health Nurse Practitioner 363LA2200X 5020246 NC Primary

Addresses

Primary practice location

4050 Piedmont Pkwy
High Point, NC 27265-9458

Mailing address

4050 Piedmont Pkwy
High Point, NC 27265-9458
Phone (336) 801-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241015002301 NC Practitioner - Nurse Practitioner 0547792590 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5020246NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus Nurse Practitioner CurrentSince Sep 1, 2024 Accepting new patients
Complexcare Medical Group Midwest M PLLC Nurse Practitioner CurrentSince May 31, 2025 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Dec 2, 2024 Accepting new patients
Theoria Medical Nurse Practitioner Past Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

969 Cox Rd
Gastonia, NC 28054
Phone (704) 266-8596

515 S Generals Blvd
Lincolnton, NC 28092
Phone (704) 733-8065

10506 Clear Creek Commerce Dr
Mint Hill, NC 28227
Phone (704) 545-2377

430 W Health Center Dr
Nags Head, NC 27959
Phone (252) 441-3116

8601 Six Forks Rd
#I
Raleigh, NC 27615

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1265140677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 PIEDMONT PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659458",
            "telephone_number": "336-801-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 PIEDMONT PKWY",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659458",
            "telephone_number": "336-801-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MIKI",
        "credential": "AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5020246",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5020246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.