1407836729 NPI number — LORA BARKE DO

Table of content: LORA BARKE DO (NPI 1407836729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407836729 NPI number — LORA BARKE DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARKE
Provider First Name:
LORA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1407836729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10800 E GEDDES AVE STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-3895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-761-9190
Provider Business Mailing Address Fax Number:
720-874-4462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 E HAMPDEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80113-2702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-761-9190
Provider Business Practice Location Address Fax Number:
720-874-4462
Provider Enumeration Date:
01/20/2006

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: 2085R0202X , with the licence number:  DOS1579 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 036100670 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 655 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 05-36532 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 45178 , 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: 200423660A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0324192 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1407836729 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 84-059792913 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 036100670 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 124182600 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1407836729 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 032646 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025709000 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1407836729 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1407836729 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00720359 . This is a "RR MCR NE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10279873 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200505370A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 73076325 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com