Individual provider Active NPI

John Bradley Allen, MD

  • Ophthalmology Physician
  • Charlotte, NC
National Provider Identifier
1689968216
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2017-00467 Issued in NC
Practice address
13532 Steelecroft Pkwy
Charlotte, NC 28278-7545
Phone
(704) 295-3475
Fax
(704) 295-3476
NPI assigned
May 31, 2011
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2017-00467 NC Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X 2017-00467 NC

Addresses

Primary practice location

13532 Steelecroft Pkwy
Charlotte, NC 28278-7545

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other identifiers 2

IdentifierTypeStateIssuer
0122221MedicaidOH
NC3146MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jallen17568@direct.ceenta.com

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
I20170919000021 NC Practitioner - Ophthalmology 0648406272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Georgia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13532 Steelecroft Pkwy
Charlotte, NC 28278-7545
Phone (704) 295-3475

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-00467NCMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Ophthalmology CurrentSince Aug 14, 2017 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA Ophthalmology CurrentSince Aug 14, 2017 Accepting new patients

Locations

13532 Steelecroft Pkwy
Charlotte, NC 28278
Phone (704) 295-3475

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

10305 Hamptons Park Dr
Ste 201
Huntersville, NC 28078
Phone (704) 295-3600

646 Hartness Rd
Statesville, NC 28677
Phone (704) 871-0081

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1689968216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000",
            "fax_number": "704-295-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13532 STEELECROFT PKWY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787545",
            "telephone_number": "704-295-3475",
            "fax_number": "704-295-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JOHN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2017-00467",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NC",
            "license": "2017-00467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122221",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC3146",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jallen17568@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "13532 Steelecroft Pkwy",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282787545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.