Active NPI
Robert W Allen, M.D.
- Pain Medicine (Anesthesiology) Physician
- Saint Louis, MO
National Provider Identifier
1780689182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 2004035409
- Practice address
- 615 S New Ballas Rd
Saint Louis, MO 63141-8221 - Phone
- (636) 386-9224
- Fax
- (636) 386-7679
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 2004035409 | MO | Primary |
Addresses
Primary practice location
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Mailing address
339 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 386-9224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207303108 | Medicaid | MO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2004035409 | MO | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1780689182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 CONSORT DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630114439",
"telephone_number": "636-386-9224",
"fax_number": "636-386-7679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S NEW BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418221",
"telephone_number": "636-386-9224",
"fax_number": "636-386-7679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "ROBERT",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MO",
"license": "2004035409",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207303108",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.