1154368777 NPI number — PAUL STEVEN BARNETT PT

Table of content: (NPI 1457613630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154368777 NPI number — PAUL STEVEN BARNETT PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNETT
Provider First Name:
PAUL
Provider Middle Name:
STEVEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

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:
1154368777
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4000 N PROVIDENCE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APPLETON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54913-8018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-257-2005
Provider Business Mailing Address Fax Number:
920-257-2004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
612B E LONGVIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APPLETON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54911-2149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-968-0814
Provider Business Practice Location Address Fax Number:
920-734-6159
Provider Enumeration Date:
06/01/2006

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:  2690-024 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 64-05777 . This is a "MEDICA-LADYSMITH" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 650007189 . This is a "RAILROAD MEDICARE/GREENBA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 40071300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64-03835 . This is a "MEDICA/ASHLAND" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 650019401 . This is a "RAILROAD MEDICARE/APPLETO" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 113455 . This is a "SECURITY HEALTH PLAN-ASHLAND/POPLAR" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 122438 . This is a "SECURITY HEALTH PLAN-WAUPACA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 650023986 . This is a "RAILROAD MEDICARE/CLINTON" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 100910 . This is a "SECURITY HEALTH GROUP" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 650019401 . This is a "RAILROAD MEDICARE/MENASHA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 100910 . This is a "SECURITY HEALTH PLAN-LADYSMITH" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 509S4BA . This is a "BCBS OF MN" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 64-03834 . This is a "MEDICA-POPLAR" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: P00460919 . This is a "RAILROAD MEDICARE/NEW LONDON" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: P00004500 . This is a "RAILROAD MEDICARE/POPLAR" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com