Individual provider Active NPI

Michael Young Allen, PA-C

  • Physician Assistant
  • Sparks, NV
National Provider Identifier
1295319986
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2737 Issued in NV
Practice address
5070 Ion Dr Ste 100
Sparks, NV 89436-1654
Phone
(775) 770-7682
Fax
(775) 770-7755
NPI assigned
May 8, 2021
Last updated
May 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2737 NV Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5070 Ion Dr Ste 100
Sparks, NV 89436-1654

Mailing address

6555 Oglala CT
Sun Valley, NV 89433-6643
Phone (775) 530-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1295319986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 OGLALA CT",
            "city": "SUN VALLEY",
            "state": "NV",
            "postal_code": "894336643",
            "telephone_number": "775-530-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 ION DR STE 100",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894361654",
            "telephone_number": "775-770-7682",
            "fax_number": "775-770-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MICHAEL",
        "middle_name": "YOUNG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-08",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2737",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.