1649248246 NPI number — DR. NORMAN F BAADE D.O.

Table of content: DR. NORMAN F BAADE D.O. (NPI 1649248246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649248246 NPI number — DR. NORMAN F BAADE D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAADE
Provider First Name:
NORMAN
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
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:
1649248246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
802 N RIVERSIDE RD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT JOSEPH
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64507-2507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-271-6418
Provider Business Mailing Address Fax Number:
816-271-6539

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 N RIVERSIDE RD
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
SAINT JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64507-9794
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-271-6518
Provider Business Practice Location Address Fax Number:
816-271-6539
Provider Enumeration Date:
03/09/2006

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: 207LP2900X , with the licence number:  R2D14 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4570113 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100234220B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10364071 . This is a "BLUE CROSS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 253173 . This is a "PHP HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2415469001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1034061 . This is a "BCBS KC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 205272503 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10001091102 . This is a "CHP" identifier . This identifiers is of the category "OTHER".




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