Jonathan Alley, D.O., P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

020014D6A Issued in IN

Legal business name

JONATHAN ALLEY, D.O., P.C.

Practice address

424 Williams St
Angola, IN 46703-1556

Phone

(260) 665-5170

Fax

(260) 665-6979

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan E Alley, D.O.NPI 1083672919

Title

Owner

Phone

(260) 665-5170

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan E Alley, D.O.

  • Family Medicine Physician
  • Angola, IN
  • NPI 1083672919

  Anesthesiology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1801112347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WILLIAMS ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467031556",
            "telephone_number": "260-665-5170",
            "fax_number": "260-665-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 WILLIAMS ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467031556",
            "telephone_number": "260-665-5170",
            "fax_number": "260-665-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN ALLEY, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "ALLEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-665-5170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "020014D6A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000000263260",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4416561",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100225890A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "5463",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Angola, IN
• Providers in Angola, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.