Active NPI
Michael M. Allen Jr.
- Customized Equipment (DME)
- Porterdale, GA
National Provider Identifier
1689519829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- License
- BR018475
- Practice address
- 2104 Main St Ste 13
Porterdale, GA 30014-3438 - Phone
- (678) 972-6944
- NPI assigned
- Apr 22, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | BR018475 | GA | |
| Specialist | 174400000X | BR018475 | GA | |
| Customized Equipment (DME) | 332BC3200X | BR018475 | GA | Primary |
Addresses
Primary practice location
2104 Main St Ste 13
Porterdale, GA 30014-3438
Mailing address
2104 Main St Ste 13
Porterdale, GA 30014-3438
Phone (678) 972-6944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BR018475 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maurice Medical | Customized Equipment | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777420800000",
"number": "1689519829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 MAIN ST STE 13",
"city": "PORTERDALE",
"state": "GA",
"postal_code": "300143438",
"telephone_number": "678-972-6944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 MAIN ST STE 13",
"city": "PORTERDALE",
"state": "GA",
"postal_code": "300143438",
"telephone_number": "678-972-6944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "MICHAEL",
"middle_name": "M.",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-22",
"last_updated": "2026-04-29",
"certification_date": "2026-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "GA",
"license": "BR018475",
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "BR018475",
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "GA",
"license": "BR018475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Porterdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.