Marcus Dwayne Allen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

89551 Issued in GA

Practice address

1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173

Phone

(770) 389-3855

NPI assigned

Apr 19, 2018

Last updated

Jul 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1487141016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-389-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 EAGLES LANDING PKWY STE 110",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815173",
            "telephone_number": "770-389-3855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Eagles Landing Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302815173",
            "country_code": "US",
            "telephone_number": "770-389-3855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24911 Little Mack Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480803200",
            "country_code": "US",
            "telephone_number": "586-777-2050",
            "fax_number": "586-777-2189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARCUS",
        "middle_name": "DWAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "89551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• All Clinical Labs Phase 1 Inc
• Candace Devon Allen-Staten, PSY.D.
• Chena Yvonne Allen, FNP
• Keosha Allen, CNA
• Leona Danielle Allen, D.C.
• Michaela Alexus Allen, PA
• Nailah Allen
• Pearline Allen, D.C.
• Tsahai Simone Allen, NP
• Allergy & Asthma Specialists

• Family Medicine Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.