Sheree Laetrell Allen, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004542 Issued in MI

Practice address

261 Mack Ave Ste 215
Detroit, MI 48201-2417

Phone

(313) 966-2539

Fax

(313) 993-2630

NPI assigned

Jan 17, 2007

Last updated

Jun 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: sallen353988@prddirect.texaschildrens.org

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.

• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1306998810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 MACK AVE STE 215",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012417",
            "telephone_number": "313-966-2539",
            "fax_number": "313-993-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MACK AVE STE 215",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012417",
            "telephone_number": "313-966-2539",
            "fax_number": "313-993-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20755 Greenfield Rd",
            "address_2": "Suite #203",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480755403",
            "country_code": "US",
            "telephone_number": "248-395-2206",
            "fax_number": "248-395-0456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20755 Greenfield Rd",
            "address_2": "Suite #203",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480755403",
            "country_code": "US",
            "telephone_number": "248-395-2206",
            "fax_number": "248-395-0456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SHEREE",
        "middle_name": "LAETRELL",
        "name_prefix": "Miss",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004542",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE #",
            "identifier": "5601004542",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nakia Venise Allen, M.D.
• Rachel Theresa Allen, MOT, OTRL
• Rodney Allen, A.M.
• Rosia Allen, LPN
• Shaquisha N Allen
• Sophia Angela Allen, MD
• Vanessa Allen
• Wendel Allen, CAC-M CSOTS
• Wilfred M Allen, NP
• Yaacob Allen

• Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.