Individual provider Active NPI

Lindsay Marie Allen, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1407105349
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006463 Issued in MI
Practice address
5973 Beatrice Drive
Kalamazoo, MI 49009
Phone
(269) 286-7110
Fax
(269) 286-7111
NPI assigned
Sep 6, 2012
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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 5601006463 MI Primary

Addresses

Primary practice location

5973 Beatrice Drive
Kalamazoo, MI 49009

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Other practice location 1

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Other names 1

  • Lindsay Marie Stephan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130208000444 MI Practitioner - Physician Assistant 8224282793 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group Michigan Inc CurrentSince Aug 1, 2013 Accepting new patients
Promed Healthcare CurrentSince Aug 1, 2013 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince May 23, 2022 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Yarrow Lodge, LLC Past Accepting new patients

Locations

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 7

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": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1407105349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641",
            "fax_number": "269-349-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5973 BEATRICE DRIVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49009",
            "telephone_number": "269-286-7110",
            "fax_number": "269-286-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W Paterson St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072557",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "fax_number": "269-349-2898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "LINDSAY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "STEPHAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.