Individual provider Active NPI

Carissa Michelle Allen, PA-C

  • Physician Assistant
  • Belmont, OH
National Provider Identifier
1346592268
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003567 Issued in OH
Practice address
66840 Belmont Morristown Rd
Belmont, OH 43718-9665
Phone
(740) 782-1031
NPI assigned
Oct 3, 2012
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003567 OH Primary

Addresses

Primary practice location

66840 Belmont Morristown Rd
Belmont, OH 43718-9665

Mailing address

66840 Belmont Morristown Rd
Belmont, OH 43718-9665
Phone (740) 782-1031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20121231000316 OH Practitioner - Physician Assistant 6103079058 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.003567OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnesville Hospital Association, Inc. CurrentSince Dec 1, 2021 Accepting new patients

Locations

639 W Main St
Barnesville, OH 43713
Phone (740) 425-3941

Organizations & group practices 1

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": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1346592268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66840 BELMONT MORRISTOWN RD",
            "city": "BELMONT",
            "state": "OH",
            "postal_code": "437189665",
            "telephone_number": "740-782-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66840 BELMONT MORRISTOWN RD",
            "city": "BELMONT",
            "state": "OH",
            "postal_code": "437189665",
            "telephone_number": "740-782-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CARISSA",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, OH

Sources for this page

Verify at the official NPI Registry.