Gary G. Allen, M.D,

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11425 Issued in AL

Practice address

101 E Brunson St
Suite 200
Enterprise, AL 36330-2526

Phone

(334) 393-3686

Fax

(334) 393-3686

NPI assigned

Aug 25, 2005

Last updated

Dec 2, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1972596849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST STE 200",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302500",
            "telephone_number": "334-393-3686",
            "fax_number": "334-393-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BRUNSON ST",
            "address_2": "SUITE 200",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302526",
            "telephone_number": "334-393-3686",
            "fax_number": "334-393-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "GARY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "11425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000036206",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51036206",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.