Active NPI
Phillip Ray Allen, FNP
- Family Nurse Practitioner
- Glide, OR
National Provider Identifier
1386076990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 200050016
- Practice address
- 182 Old Cabin Dr
182 Old Cabin Drive
Glide, OR 97443-9750 - Phone
- (541) 496-0013
- NPI assigned
- Aug 6, 2013
- Last updated
- Aug 6, 2013
- 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 Nurse Practitioner | 363LF0000X | 200050016 | OR | Primary |
Addresses
Primary practice location
182 Old Cabin Dr
182 Old Cabin Drive
Glide, OR 97443-9750
Mailing address
182 Old Cabin Dr
182 Old Cabin Drive
Glide, OR 97443-9750
Phone (541) 496-0013
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200050016 | OR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375747200000",
"number": "1386076990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "182 OLD CABIN DR",
"address_2": "182 OLD CABIN DRIVE",
"city": "GLIDE",
"state": "OR",
"postal_code": "974439750",
"telephone_number": "541-496-0013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "182 OLD CABIN DR",
"address_2": "182 OLD CABIN DRIVE",
"city": "GLIDE",
"state": "OR",
"postal_code": "974439750",
"telephone_number": "541-496-0013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "PHILLIP",
"middle_name": "RAY",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-06",
"last_updated": "2013-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "200050016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glide, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.