Lesley Jo Allen, APRN
Individual provider Active NPI Nurse Practitioner · Greendale, IN
NPI 1376793349 · NPPES record last updated Jul 18, 2024
Key facts
- NPI
- 1376793349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71015390A (IN)
- Practice address
- 1640 Flossie Dr
Greendale, IN 47025-8424 - Phone
- (812) 496-3285
- Fax
- (812) 537-0400
- NPI assigned
- Sep 25, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Cincinnati College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Medical Group Inc
Practice addresses (Care Compare)
1640 Flossie Dr
Greendale, IN 47025-8424
Phone (812) 496-3285
405 Violet Rd
Crittenden, KY 41030-8956
Phone (859) 428-1610
Hospital & facility affiliations
- St Elizabeth Edgewood
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140211001241 | KY | Practitioner - Nurse Practitioner | 6800937020 | Reassigns benefits to 2 organizations |
| I20240730003986 | IN | Practitioner - Nurse Practitioner | 6800937020 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.10389-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc | Nurse Practitioner | Current |
Accepting new patients |
| Summit Medical Group, Inc. | Current |
Accepting new patients | |
| Summit Medical Group, Inc. | Nurse Practitioner | Current |
Accepting new patients |
| Summit Medical Group, Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133
1640 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 496-3285
405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610
1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- lallen@coc1897.srs-direct.com
- lallen163151@direct-prd.stelizabeth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA.10389-NP | OH | |
| Family Nurse Practitioner | 363LF0000X | 3005659 | KY | |
| Nurse Practitioner | 363L00000X | 71015390A | IN | Yes |
| Nurse Practitioner | 363L00000X | 3005659 | KY |
Addresses
Primary practice location
1640 Flossie Dr
Greendale, IN 47025-8424
Mailing address
560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663
Other practice location 1
560 S Loop RD
Edgewood, KY 41017-3405
Phone (859) 301-2663
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100098260 | Medicaid | KY |
Other names
- Lesley Brock
Other providers in Greendale, IN
- Accudoc Inc PC
- Sydney Nicole Berlin
- Gerald Thomas Bowen
- Josie Bressert
- Hannah Briner
- Jamie Lynn Burgess
All providers in Greendale, IN · Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.