Individual provider Active NPI

Allyn Noelle Farmer, PA

  • Surgical Physician Assistant
  • Memphis, TN
National Provider Identifier
1891068631
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
10001395A Issued in IN
Practice address
80 Humphreys Center Dr Ste 100
Memphis, TN 38120-2352
Phone
(901) 761-9030
Fax
(901) 761-9591
NPI assigned
Feb 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 814 AL
Surgical Physician Assistant 363AS0400X 10001395A IN Primary

Addresses

Primary practice location

80 Humphreys Center Dr Ste 100
Memphis, TN 38120-2352

Mailing address

PO Box 1000 Dept 245
Memphis, TN 38148-0001
Phone (901) 761-9030

Other identifiers 3

IdentifierTypeStateIssuer
000000779998OtherINANTHEM PROVIDER NUMBER
2555OtherTNTN MEDICAL LICENSE
PA 814OtherALSTATE BOARD OF MEDICAL EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20141002002062 TN Practitioner - Physician Assistant 4789843525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Plastic Surgery Group of Memphis P.C.Group PAC ID 6608854013, 7 clinicians

Practice addresses (Care Compare)

80 Humphreys Ctr Dr
Suite 100
Memphis, TN 38120-2352
Phone (901) 761-9030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2555TNMDProfessional Counselor
PA 814ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Neurodiagnostic Lab LLC PastSince Mar 1, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: afarmer22098@mlh.direct-ci.com
  • Direct secure messaging: allyn.farmer@psgm.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1891068631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 245",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-761-9030",
            "fax_number": "901-761-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HUMPHREYS CENTER DR STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202352",
            "telephone_number": "901-761-9030",
            "fax_number": "901-761-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "ALLYN",
        "middle_name": "NOELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA 814",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10001395A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000779998",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN MEDICAL LICENSE",
            "identifier": "2555",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF MEDICAL EXAMINERS",
            "identifier": "PA 814",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.