Individual provider Active NPI

William R Allen, MD

  • Urology Physician
  • Lexington, KY
National Provider Identifier
1740286921
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
20000 Issued in KY
Practice address
4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3062
Phone
(859) 971-4695
Fax
(859) 971-4604
NPI assigned
Jun 22, 2005
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 20000 KY Primary

Addresses

Primary practice location

4071 Tates Creek Centre Dr
Suite 202
Lexington, KY 40517-3062

Mailing address

793 Eastern Byp
Ste 101
Richmond, KY 40475-2422
Phone (859) 626-8645

Other identifiers 2

IdentifierTypeStateIssuer
64200009MedicaidKY
K191130OtherKYMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wallen38953@bhkydirect.com

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20000KYMDUrology Physician

Interoperability endpoints

  • Direct secure messaging: wallen38953@bhkydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1740286921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 EASTERN BYP",
            "address_2": "STE 101",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752422",
            "telephone_number": "859-626-8645",
            "fax_number": "859-626-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 TATES CREEK CENTRE DR",
            "address_2": "SUITE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173062",
            "telephone_number": "859-971-4695",
            "fax_number": "859-971-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "20000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64200009",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K191130",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wallen38953@bhkydirect.com",
            "affiliation": "N",
            "address_1": "793 Eastern Byp Ste 101",
            "city": "Richmond",
            "state": "KY",
            "country_code": "US",
            "postal_code": "404752425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.