Individual provider Active NPI

Elizabeth Cobey Allen, MD

  • Developmental - Behavioral Pediatrics Physician
  • Winston Salem, NC
National Provider Identifier
1487639464
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
18988 Issued in NC
Practice address
Medical Center Blvd
Winston-Salem, NC 27157
Phone
(336) 716-2255
NPI assigned
Dec 13, 2005
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 18988 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston-Salem, NC 27157

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other identifiers 8

IdentifierTypeStateIssuer
8910744MedicaidNC
Q31226MedicaidSC
1869014000MedicaidWV
5653213OtherAETNA
10744OtherBCBS
5149OtherPARTNERS
64155OtherMEDCOST
6764371MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address EALLEN146001@DIRECT.NOVANT.ORG Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100423000493 NC Practitioner - Pediatric MedicinePractitioner - Other (Physician) 7618004557 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18988NCMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 23, 2023 Accepting new patients
Novant Health Medical Group LLC CurrentSince May 23, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

5175 Old Clemmons School Rd
Clemmons, NC 27012
Phone (336) 718-3960

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: eallen146001@direct.novant.org
  • Direct secure messaging: eallen146001@direct.novanthealth.org

Organizations & group practices 4

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1487639464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ELIZABETH",
        "middle_name": "COBEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NC",
            "license": "18988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910744",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q31226",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1869014000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5653213",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10744",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "5149",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "64155",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6764371",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EALLEN146001@DIRECT.NOVANT.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "Medical Center Blvd",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.