Individual provider Active NPI

Kirsten Allen, PSY.D.

  • Rehabilitation Psychologist
  • Atlanta, GA
National Provider Identifier
1457758229
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
License
004309 Issued in GA
Practice address
80 Peachtree Park Dr NE
Atlanta, GA 30309-1304
Phone
(404) 603-4314
NPI assigned
Nov 22, 2014
Last updated
Aug 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X 004309 GA Primary

Addresses

Primary practice location

80 Peachtree Park Dr NE
Atlanta, GA 30309-1304

Mailing address

1685 Briarcliff Rd NE Apt 6
Atlanta, GA 30306-2127
Phone (859) 552-7367

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112003022 GA Practitioner - Clinical Psychologist 8426480492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shepherd Center, Inc.Group PAC ID 1052301777, 51 clinicians

Practice addresses (Care Compare)

2020 Peachtree Rd NW
Atlanta, GA 30309-1426
Phone (404) 352-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shepherd Center Inc CurrentSince Sep 16, 2019 Accepting new patients

Locations

2020 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 350-7333

80 Peachtree Park Dr NE
Atlanta, GA 30309
Phone (404) 603-4314

Organizations & group practices 1

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": "1416614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1457758229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 BRIARCLIFF RD NE APT 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303062127",
            "telephone_number": "859-552-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PEACHTREE PARK DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091304",
            "telephone_number": "404-603-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KIRSTEN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-22",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "GA",
            "license": "004309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.