Active NPI
Raymond K Allen, MD
- Family Medicine Physician
- Kingstree, SC
National Provider Identifier
1932192192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11529
- Practice address
- 512 Nelson Blvd
Suite 200
Kingstree, SC 29556-4027 - Phone
- (843) 355-5459
- Fax
- (843) 355-9704
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11529 | SC | Primary |
Addresses
Primary practice location
512 Nelson Blvd
Suite 200
Kingstree, SC 29556-4027
Mailing address
PO Box 3239
Florence, SC 29502-3239
Phone (843) 777-7162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115299 | Medicaid | SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | raymond.allen@mpaii.eclinicaldirectplus.com | Direct |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kingstree Family Medicine PA | Family Medicine | Current | Accepting new patients |
Locations
512 Nelson Blvd
#200
Kingstree, SC 29556
Phone (843) 354-5459
Organizations & group practices 1
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": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1932192192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3239",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295023239",
"telephone_number": "843-777-7162",
"fax_number": "843-777-7102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 NELSON BLVD",
"address_2": "SUITE 200",
"city": "KINGSTREE",
"state": "SC",
"postal_code": "295564027",
"telephone_number": "843-355-5459",
"fax_number": "843-355-9704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "RAYMOND",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "11529",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115299",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "raymond.allen@mpaii.eclinicaldirectplus.com",
"affiliation": "N",
"endpointDescription": "ECW DA",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "EHR",
"address_1": "512 Nelson Blvd",
"address_2": "Suite 200",
"city": "Kingstree",
"state": "SC",
"country_code": "US",
"postal_code": "295564027",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kingstree, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.