1235310145 NPI number — DR. RACHEL LYNN YATES MD

Table of content: DR. RACHEL LYNN YATES MD (NPI 1235310145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235310145 NPI number — DR. RACHEL LYNN YATES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YATES
Provider First Name:
RACHEL
Provider Middle Name:
LYNN
Provider Name Prefix Text:
DR.
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:
1235310145
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/15/2025
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 110
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:
303-801-0129
Provider Business Mailing Address Fax Number:
303-586-8206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2030 MOUNTAIN VIEW AVE
Provider Second Line Business Practice Location Address:
SUITE 540
Provider Business Practice Location Address City Name:
LONGMONT
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80501-3178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-951-4059
Provider Business Practice Location Address Fax Number:
303-951-4060
Provider Enumeration Date:
11/19/2007

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: 207Q00000X , with the licence number:  A98805 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: DR.0046590 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 46590 , 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: 25287214 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022777 . This is a "KAISER COMMERCIAL NUMBER" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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