Individual provider Active NPI

Jon David Allison, PAC

  • Medical Physician Assistant
  • Denver, CO
National Provider Identifier
1609812668
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1935 Issued in CO
Practice address
1400 Jackson St
Denver, CO 80206-2761
Phone
(303) 388-4461
Fax
(303) 398-1211
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1935 CO Primary

Addresses

Primary practice location

1400 Jackson St
Denver, CO 80206-2761

Mailing address

1400 Jackson St
Denver, CO 80206-2761
Phone (303) 388-4461

Other identifiers 2

IdentifierTypeStateIssuer
1935OtherCOPHYSICIAN ASSISTANT
88722325MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NJHealth@njc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20040701000003 CO Practitioner - Physician Assistant 1254318942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1400 Jackson St
Denver, CO 80206-2761

1400 Jackson St
Denver, CO 80206-2762

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1935COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Valley Gastroenterology Inc. CurrentSince Nov 1, 2017 Accepting new patients
Boulder Valley Gastroenterology Inc. CurrentSince Nov 1, 2017 Accepting new patients
Western Slope Cardiology, PC Past Accepting new patients

Locations

1000 W South Boulder Rd
Ste 200
Lafayette, CO 80026
Phone (303) 604-4664

13952 Denver West Pkwy
Ste 100
Lakewood, CO 80401
Phone (303) 271-1112

382 S Arthur Ave
Louisville, CO 80027

382 S Arthur Ave
Unit 100
Louisville, CO 80027

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1609812668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062761",
            "telephone_number": "303-388-4461",
            "fax_number": "303-398-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062761",
            "telephone_number": "303-388-4461",
            "fax_number": "303-398-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "JON",
        "middle_name": "DAVID",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "1935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "1935",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88722325",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJHealth@njc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1400 Jackson St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802062761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.