Christian Frederick Allen, P.A.
Individual provider Active NPI Anesthesiologist Assistant · Marietta, GA
NPI 1720060122 · NPPES record last updated Jun 17, 2020
Key facts
- NPI
- 1720060122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiologist Assistant 367H00000X
- License
- 2844 (GA)
- Practice address
- 677 Church St NE
Marietta, GA 30060-1101 - Phone
- (770) 794-0477
- Fax
- (770) 794-3108
- NPI assigned
- Nov 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology Assistant
- Education
- Emory University School of Medicine, 1995
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Mak Anesthesia Holdings, LLC
Wellstar Medical Group LLC
Practice addresses (Care Compare)
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041130001010 | GA | Practitioner - Anesthesiology Assistant | 6305801473 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Associate of Arts, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214 | GA | MD | Acupuncturist |
| 2844 | GA | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Redmond Anesthesia and Pain Treatment, PC | Current |
Accepting new patients | |
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Pain Solutions Treatment Centers | Past | Accepting new patients | |
| Tri-County Anesthesia, LLC | Past | Accepting new patients | |
| Metro West Anesthesia | Past | Accepting new patients | |
| Southeast Anesthesia PC | Past | Accepting new patients |
Locations
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
8954 Hospital Dr
Ste 115B
Douglasville, GA 30134
Phone (678) 838-2532
8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584
144 Bill Carruth Pkwy
Ste 2300
Hiram, GA 30141
Phone (770) 590-1078
146 Bill Carruth Pkwy
Hiram, GA 30141
Phone (770) 443-4775
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
2540 Windy Hill Rd SE
Marietta, GA 30067
Phone (470) 644-1274
677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435
501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291
3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002844 | GA | |
| Anesthesiologist Assistant | 367H00000X | 2844 | GA | Yes |
Addresses
Primary practice location
677 Church St NE
Marietta, GA 30060-1101
Mailing address
PO Box 1950
Douglasville, GA 30133-1950
Phone (706) 660-8505
Other practice location 1
146 Bill Carruth Pkwy
Hiram, GA 30141-3749
Phone (770) 794-0477
Other practice location 2
8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (770) 920-6413
Other practice location 3
2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (770) 794-0477
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 640402698A | Medicaid | GA | |
| 491431789A | Medicaid | GA |
Other providers in Marietta, GA
- Allen Surgical LLC
- Ashli Dian Allen
- Brennan Allen
- Charles Daniel Allen III
- Chloe Winn Allen
- Craig James Allen
- Latifah Ashley Allen
- Sarah Allen
- Shelby Gutierrez Allen
- Shelly Allen
All providers in Marietta, GA · Anesthesiologist Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.