Individual provider Active NPI

Preston McClain Allison, DO

  • Obstetrics & Gynecology Physician
  • Grand Rapids, MI
National Provider Identifier
1629677091
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5151017435 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 391-2160
Fax
(616) 391-2683
NPI assigned
Oct 18, 2020
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5151017435 MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 391-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250505002083 MI Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 8325565237

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1629677091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-2160",
            "fax_number": "616-391-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-2160",
            "fax_number": "616-391-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "PRESTON",
        "middle_name": "MCCLAIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-18",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5151017435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.