Individual provider Active NPI

Brian S Allshouse, PA-C

  • Surgical Physician Assistant
  • Prescott, AZ
National Provider Identifier
1801823372
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1951 Issued in AZ
Practice address
811 Ainsworth Dr
Suite 109
Prescott, AZ 86301-1687
Phone
(928) 771-5595
Fax
(928) 771-5596
NPI assigned
Jun 28, 2006
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1951 AZ Primary

Addresses

Primary practice location

811 Ainsworth Dr
Suite 109
Prescott, AZ 86301-1687

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5987

Other practice location 1

3262 N Windsong Dr Ste A
Prescott Valley, AZ 86314-2255
Phone (928) 771-5595

Other practice location 2

1739 E Beverly Ave Ste 221
Kingman, AZ 86409-3593
Phone (928) 771-5595

Other identifiers 1

IdentifierTypeStateIssuer
374009MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000240 AZ Practitioner - Physician Assistant 9436190550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1003 Willow Creek Rd
Prescott, AZ 86301-1641

3120 Clearwater Dr
Prescott, AZ 86305-7131
Phone (928) 771-3704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1951AZMDClinical Psychologist
1951ALMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Nov 1, 2019 Accepting new patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Nov 1, 2019 Accepting new patients
Nextcare Arizona I JV LLC Past Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

1739 E Beverly Ave
Ste 221
Kingman, AZ 86409
Phone (928) 681-8671

1001 Willow Creek Rd
Ste 3200
Prescott, AZ 86301
Phone (928) 771-5595

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

811 Ainsworth Dr
Ste 109
Prescott, AZ 86301
Phone (928) 771-5595

3262 N Windsong Dr
Prescott Valley, AZ 86314
Phone (928) 759-5800

3262 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 771-5595

Organizations & group practices 6

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 1

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1801823372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5987",
            "fax_number": "928-458-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 AINSWORTH DR",
            "address_2": "SUITE 109",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011687",
            "telephone_number": "928-771-5595",
            "fax_number": "928-771-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3262 N Windsong Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142255",
            "country_code": "US",
            "telephone_number": "928-771-5595",
            "fax_number": "928-771-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1739 E Beverly Ave Ste 221",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "AZ",
            "postal_code": "864093593",
            "country_code": "US",
            "telephone_number": "928-771-5595",
            "fax_number": "928-771-5596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLSHOUSE",
        "first_name": "BRIAN",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "1951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374009",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.