1659485068 NPI number — LORI CHRISTINE CATE M.P.T.

Table of content: LORI CHRISTINE CATE M.P.T. (NPI 1659485068)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659485068 NPI number — LORI CHRISTINE CATE M.P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CATE
Provider First Name:
LORI
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RIEGLE
Provider Other First Name:
LORI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659485068
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 13269
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32317-3269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-219-1520
Provider Business Mailing Address Fax Number:
850-219-1521

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2887 CRAWFORDVILLE HWY.
Provider Second Line Business Practice Location Address:
UNIT 3
Provider Business Practice Location Address City Name:
CRAWFORDVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-926-8555
Provider Business Practice Location Address Fax Number:
850-926-2402
Provider Enumeration Date:
08/19/2006

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: 225100000X , with the licence number:  PTH4288 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000062200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11991102 . This is a "CAQH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 51537348 . This is a "BLUE CROSS BLUE SHIELD AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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