Individual provider Active NPI

Lesley Jo Allen, APRN

  • Nurse Practitioner
  • Greendale, IN
National Provider Identifier
1376793349
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71015390A Issued in IN
Practice address
1640 Flossie Dr
Greendale, IN 47025-8424
Phone
(812) 496-3285
Fax
(812) 537-0400
NPI assigned
Sep 25, 2008
Last updated
Jul 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.10389-NP OH
Family Nurse Practitioner 363LF0000X 3005659 KY
Nurse Practitioner 363L00000X 71015390A IN Primary
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 names 1

  • Lesley Brock Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140211001241 KY Practitioner - Nurse Practitioner 6800937020 Reassigns benefits to 2 organizations
I20240730003986 IN Practitioner - Nurse Practitioner 6800937020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 2163326240, shared by 11 NPIs, 803 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3005659KYMDNurse Practitioner
COA.10389-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jul 22, 2024 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner Current Accepting new patients
Summit Medical Group, Inc Nurse Practitioner CurrentSince Jul 22, 2024 Accepting new patients
Summit Medical Group, Inc. Nurse Practitioner CurrentSince Jul 22, 2024 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

  • Direct secure messaging: lallen@coc1897.srs-direct.com
  • Direct secure messaging: lallen163151@direct-prd.stelizabeth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1376793349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 FLOSSIE DR",
            "city": "GREENDALE",
            "state": "IN",
            "postal_code": "470258424",
            "telephone_number": "812-496-3285",
            "fax_number": "812-537-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 S Loop RD",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173405",
            "country_code": "US",
            "telephone_number": "859-301-2663",
            "fax_number": "859-301-0655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "LESLEY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.10389-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3005659",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71015390A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3005659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLEY",
            "last_name": "BROCK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greendale, IN

Sources for this page

Verify at the official NPI Registry.