Desiree Juanita Allen

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

496 Quail Crest Dr
Collierville, TN 38017-1750

Phone

(617) 824-0421

NPI assigned

Sep 16, 2022

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glory Carriers Transportation LLC

  • Non-emergency Medical Transport (VAN)
  • Collierville, TN
  • NPI 1962104919
  NPD Authorized official NON-EMERGENCY MEDICAL TRANSPORT (VAN)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 20, 2023.

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1821710690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 HACKS CROSS RD STE 102-304",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252367",
            "telephone_number": "617-824-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 QUAIL CREST DR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380171750",
            "telephone_number": "617-824-0421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3750 Hacks Cross Rd Ste 102-304",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381252367",
            "country_code": "US",
            "telephone_number": "617-824-0421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "DESIREE",
        "middle_name": "JUANITA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220006017",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "220006017",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Gctrans.tn@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3750 Hacks Cross Rd Ste 102-304",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381252367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Collierville, TN
• Non-emergency Medical Transport (VAN) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.