Active NPI
Jay Ronald Allen, M.D.
- Family Medicine Physician
- Kirtland AFB, NM
National Provider Identifier
1346203809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37419
- Practice address
- 2050A 2ND St SE
Kirtland AFB, NM 87117-5522 - Phone
- (505) 846-3562
- NPI assigned
- Apr 7, 2006
- Last updated
- Mar 24, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37419 | CO | Primary |
Addresses
Primary practice location
2050A 2ND St SE
Kirtland AFB, NM 87117-5522
Mailing address
845 N Humboldt St
Denver, CO 80218-3513
Phone (781) 605-7815
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37419 | CO | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616544000000",
"number": "1346203809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 N HUMBOLDT ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802183513",
"telephone_number": "781-605-7815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050A 2ND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "505-846-3562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JAY",
"middle_name": "RONALD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-07",
"last_updated": "2021-03-24",
"certification_date": "2021-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "37419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland AFB, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.