1346346798 NPI number — DR. JAMES T BARR DC, CCSP

Table of content: DR. JAMES T BARR DC, CCSP (NPI 1346346798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346346798 NPI number — DR. JAMES T BARR DC, CCSP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARR
Provider First Name:
JAMES
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC, CCSP
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:
1346346798
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4719 BANNING AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE BEAR LAKE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55110-3217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-429-2279
Provider Business Mailing Address Fax Number:
651-429-2361

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4719 BANNING AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE BEAR LAKE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55110-3217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-429-2279
Provider Business Practice Location Address Fax Number:
651-429-2361
Provider Enumeration Date:
09/15/2006

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: 111N00000X , with the licence number:  2177-012 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 2310 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 24549 . This is a "SECURITY HEALTH PLAN" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 38797400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4404853 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: CJ7409 . This is a "RAILROAD MEDICARE GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 350022884 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 3AN69BA . This is a "BCBS MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: P00775087 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: CC1784A . This is a "CHIROCARE" identifier . This identifiers is of the category "OTHER".




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