1528248697 NPI number — MRS. JACKI RALENE BUFFINGTON-REIDER AU.D, CCC-A

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528248697 NPI number — MRS. JACKI RALENE BUFFINGTON-REIDER AU.D, CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUFFINGTON-REIDER
Provider First Name:
JACKI
Provider Middle Name:
RALENE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AU.D, CCC-A
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:
1528248697
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
445 UNION BLVD STE 124
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80228-1239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-233-3142
Provider Business Mailing Address Fax Number:
303-233-3719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3400 W 16TH ST BLDG 1N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREELEY
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80634-6862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-634-0600
Provider Business Practice Location Address Fax Number:
303-233-3719
Provider Enumeration Date:
11/06/2007

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: 231H00000X , with the licence number:  502 , 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)





Copyright © 2007-2026 www.npivalidator.com