Individual provider Active NPI

Shawn Patrice Allen, M.D.

  • Psychiatry Physician
  • Tucker, GA
National Provider Identifier
1437316635
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
038168 Issued in GA
Practice address
1479 Brockett Rd Ste 101
Tucker, GA 30084-7326
Phone
(404) 625-5427
Fax
(404) 508-8944
NPI assigned
May 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 038168 GA Primary

Addresses

Primary practice location

1479 Brockett Rd Ste 101
Tucker, GA 30084-7326

Mailing address

1633 Spruce Pine CT SW
Lilburn, GA 30047-5671
Phone (404) 630-5831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121228000327 GA Practitioner - Psychiatry 5698928596 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renewed Journey Counseling Services LLCGroup PAC ID 3476696147, 2 clinicians

Practice addresses (Care Compare)

1479 Brockett Rd
Suite 101
Tucker, GA 30084-7326
Phone (404) 625-5427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038168GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chris 180, Inc. CurrentSince Apr 16, 2015 Accepting new patients

Locations

1017 Fayetteville Rd SE
Atlanta, GA 30316
Phone (404) 324-4190

3103 Clairmont Rd NE
Ste B
Brookhaven, GA 30329
Phone (678) 302-1945

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1437316635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 SPRUCE PINE CT SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300475671",
            "telephone_number": "404-630-5831",
            "fax_number": "404-508-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 BROCKETT RD STE 101",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847326",
            "telephone_number": "404-625-5427",
            "fax_number": "404-508-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SHAWN",
        "middle_name": "PATRICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "038168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.