BROOKE A LANGE PA-C NPI 1093103038

NPI Information

  • NPI: 1093103038
  • Provider Name: BROOKE A LANGE, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 830 W HIGH ST STE 360
    LIMA, OH
    ZIP 45801
  • Phone: (419) 227-7117

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NPI Details

Brooke A Lange, PA-C is a medical physician assistant in Lima, OH. Brooke A Lange, PA-C NPI is 1093103038. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

830 W HIGH ST STE 360
LIMA, OH
ZIP 45801-985
Phone: (419) 227-7117
Fax: (419) 227-2848

The NPI 1093103038 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/29/2014 and was last updated on 4/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical50.004109OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10105065OTHEROHIOMEDICAID GROUP
29943723OTHEROHIOMEDICARE GROUP PTAN
334-1689161OTHEROHIOGROUP TIN
41184652539OTHEROHIOGROUP NPI
50116351MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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