Individual provider Active NPI

William B Allen, RPT,ATC

  • Physical Therapist
  • Fort Scott, KS
National Provider Identifier
1356452502
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-03320 Issued in KS
Practice address
1623 S Main St
Fort Scott, KS 66701-2656
Phone
(620) 223-4555
NPI assigned
Aug 31, 2006
Last updated
Dec 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-03320 KS Primary

Addresses

Primary practice location

1623 S Main St
Fort Scott, KS 66701-2656

Mailing address

107 N Pine St Ste a
PO Box 1539
Pittsburg, KS 66762-4743
Phone (620) 231-5855

Other identifiers 2

IdentifierTypeStateIssuer
140952OtherKSBCBS
462987MedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000126 KS Practitioner - Physical Therapist in Private Practice 7618972555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1623 S Main St
Fort Scott, KS 66701-2656
Phone (620) 223-4555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-03320KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sek Otolaryngology Past Accepting new patients

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1356452502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N PINE ST STE A",
            "address_2": "PO BOX 1539",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667624743",
            "telephone_number": "620-231-5855",
            "fax_number": "620-231-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 S MAIN ST",
            "city": "FORT SCOTT",
            "state": "KS",
            "postal_code": "667012656",
            "telephone_number": "620-223-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "RPT,ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "140952",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462987",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Scott, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.