1144281155 NPI number — MEGAN M MAHONEY MD

Table of content: MEGAN M MAHONEY MD (NPI 1144281155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144281155 NPI number — MEGAN M MAHONEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAHONEY
Provider First Name:
MEGAN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144281155
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2233 E MAIN ST
Provider Second Line Business Mailing Address:
BUSINESS OPTIONS MEDICAL BILLING
Provider Business Mailing Address City Name:
MONTROSE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81401-3831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-765-0818
Provider Business Mailing Address Fax Number:
970-497-8410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81425-0529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-323-6141
Provider Business Practice Location Address Fax Number:
970-323-6117
Provider Enumeration Date:
03/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  32529 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 38854 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 51303 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 139H0MA . This is a "BCBSMN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 371020YS6E . This is a "MEDICARE B PTAN FOR OLATHE COMMUNITY CLINIC DBA RVFHC" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: P00449455 . This is a "RR MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9174425 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 34712700 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: COA108893 . This is a "MEDICARE PTAN BASIN CLINIC, NATURITA, CO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 803521100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: HP69913 . This is a "HEALTHPARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05622778 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112858 . This is a "UCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P01327013 . This is a "RAILROAD WORKERS MEDICARE, BASIN CLINIC, NATURITA, CO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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