MARK ALLEN (NPI# 1124339676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124339676 |
| Entity Type | Individual |
| Full Name | MARK ALLEN |
| Credential | D.O. |
| Practice Address |
1505 Wigwam Pkwy Ste 330 Henderson NV 89074 |
| Mailing Address |
7455 W Washington Ave Ste 160 Las Vegas NV 89128-4356 |
| Practice Telephone | 7028780393 |
| Practice Fax Number | 7029661554 |
| Mailing Telephone | 7028780393 |
| Mailing Fax Number | 7029024580 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2019-01-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | DO2401 | NV | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 006630 | AZ | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1505 Wigwam Pkwy Ste 330, Henderson, NV 89074 | 7028780393 | 7029661554 |
| 10494 W Thunderbird Blvd Ste 102, Sun City, AZ 853516122 | 8669742673 | 8669392673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720539406 | Mark Allen | Nursing Facility/Intermediate Care Facility | 219 Deerfoot Trl, Kalispell, MT 59901-8725 | 2016-10-18 |
| 1942509559 | Mark Allen | Counselor | 1384 W Ellery Way, Fresno, CA 93711-2014 | 2011-03-22 |
| 1134283765 | Mark S Allen | Dentist | 1716 Ashley Cir, Bowling Green, KY 42104-3366 | 2006-12-20 |
| 1952471617 | Mark Allen | Chiropractor | 434 S Green St, Henderson, KY 42420-3517 | 2006-11-09 |
| 1306934708 | Mark A. Allen | Chiropractor | 2525 California St, Suite A&b, Columbus, IN 47201-3678 | 2006-10-11 |
| 1467551549 | Mark H Allen | Optometrist | 4810 Lakeland Dr, Flowood, MS 39232-8694 | 2006-09-22 |
| 1295742013 | Mark Jay Allen | Dentist | 519 S Santa Fe Ave, Edmond, OK 73003-6281 | 2006-08-02 |
| 1700842549 | Mark Allen | Dentist | 151 North Main St, Hardwick, VT 05843 | 2006-04-21 |
| 1932187507 | Mark Daniel Allen | Nurse Practitioner | 1400 Willow Lane, Manchester, TN 37355 | 2006-01-04 |
| 1790768182 | Mark Erich Allen | Chiropractor | 894 Broadway, South Portland, ME 04106-4350 | 2005-11-21 |
| Street Address |
1505 WIGWAM PKWY STE 330 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487045936 | Jason A Zarn | Physician Assistant | 1505 Wigwam Pkwy Ste 330, Henderson, NV 89074-8195 | 2015-02-05 |
| 1699041970 | Kevin Reza Golshani | Orthopaedic Surgery | 1505 Wigwam Pkwy Ste 330, Henderson, NV 89074-8195 | 2012-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1811421712 | Henderson Long Term Care LLC | Skilled Nursing Facility | 2965 Wigwam Parkway, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437531902 | Laura M. Bruse, M.d., P.C. | Orthopaedic Surgery | 1452 W. Horizon Ridge Pkwy #510, Henderson, NV 89012 | 2015-06-22 |
| 1396087623 | Carl Bradley Wallis | Orthopaedic Surgery | 10561 Jeffreys St Ste 230, Henderson, NV 89052-4268 | 2013-03-25 |
| 1447480413 | Private Diagnostic Clinic, Pllc | Orthopaedic Surgery | 511 Ruin Road, Suite 106, Henderson, NC 27536-5919 | 2009-07-23 |
| 1588793533 | Caleb Ogden Pinegar | Orthopaedic Surgery | 2779 W Horizon Ridge Pkwy Ste 200, Henderson, NV 89052-4186 | 2007-03-05 |
| 1033269147 | Michael J Crovetti Jr. | Orthopaedic Surgery | 2779 W. Horizon Ridge Pkwy., Ste. 200, Henderson, NV 89052-4380 | 2007-01-11 |
| 1942243324 | Ronald Curtis Koe | Orthopaedic Surgery | 1710 W. Horizon Ridge Pkwy, Ste 120, Henderson, NV 89012 | 2006-06-14 |
| 1376500181 | Frederick Charles Balduini | Orthopaedic Surgery | 2779 W Horizon Ridge, Ste 200, Henderson, NV 89052-4380 | 2006-04-26 |
| 1104893031 | Frederick Charles Redfern | Orthopaedic Surgery | 1701 N Green Valley Pkwy Ste 4b, Henderson, NV 89074-5886 | 2006-02-28 |
| 1750371233 | John E Herr | Orthopaedic Surgery | 1701 N Green Valley Pkwy Ste 4c, Henderson, NV 89074-5886 | 2005-10-25 |
| 1922007244 | Patrick S. Mcnulty | Orthopaedic Surgery | 3175 Saint Rose Pkwy Ste 320, Henderson, NV 89052-3508 | 2005-07-19 |
| Find all providers in HENDERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.