Active NPI
William Chase Allen, CSA
- Surgical Assistant
- Roswell, GA
National Provider Identifier
1891093860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 3716
- Practice address
- 8025 Sandorn Dr
Roswell, GA 30075-6733 - Phone
- (321) 231-6594
- NPI assigned
- Mar 1, 2011
- Last updated
- Mar 26, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 3716 | GA | Primary |
Addresses
Primary practice location
8025 Sandorn Dr
Roswell, GA 30075-6733
Mailing address
8025 Sandorn Dr
Roswell, GA 30075-6733
Phone (321) 231-6594
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3716 | GA | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1891093860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8025 SANDORN DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300756733",
"telephone_number": "321-231-6594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8025 SANDORN DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300756733",
"telephone_number": "321-231-6594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "WILLIAM",
"middle_name": "CHASE",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-01",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "GA",
"license": "3716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.