1306976519 NPI number — CLEAR SKY MEDICAL, PC

Table of content: BARBARA ANN LAIR LCSW (NPI 1023021656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306976519 NPI number — CLEAR SKY MEDICAL, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEAR SKY MEDICAL, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1306976519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9085 E MINERAL CIR
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
CENTENNIAL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-3462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-790-7860
Provider Business Mailing Address Fax Number:
855-421-3745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9085 E MINERAL CIR
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
CENTENNIAL
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-3462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-790-7860
Provider Business Practice Location Address Fax Number:
855-421-3745
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MEIER
Authorized Official First Name:
KATHARINA KATJA
Authorized Official Middle Name:
ISABEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
303-790-7860

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  44224 , 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: 1144266180 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1306976519 . This is a "NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 44224 . This is a "LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: COB4372 . This is a "PTAN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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