1821079294 NPI number — DR. BRIDGETTE ANNE OSTMEYER O.D

Table of content: DR. BRIDGETTE ANNE OSTMEYER O.D (NPI 1821079294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821079294 NPI number — DR. BRIDGETTE ANNE OSTMEYER O.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSTMEYER
Provider First Name:
BRIDGETTE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D
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:
1821079294
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2800 SW WANAMAKER RD
Provider Second Line Business Mailing Address:
SUITE 192
Provider Business Mailing Address City Name:
TOPEKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66614-4293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-272-0707
Provider Business Mailing Address Fax Number:
785-271-1512

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4745 NW HUNTERS RIDGE CIR
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66618-2538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-246-3937
Provider Business Practice Location Address Fax Number:
785-246-0527
Provider Enumeration Date:
11/10/2005

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: 152W00000X , with the licence number:  KS-1490-3 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 651058 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 222929 . This is a "COLE VISION" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 480950 . This is a "FIRSTGUARD" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 100275260D , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 651021 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 651047 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com