BROOKE A LANGE PA-C NPI 1093103038

NPI Information

NPI: 1093103038
Provider Name: BROOKE A LANGE, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
830 W HIGH ST STE 360
LIMA, OH
ZIP 45801
Phone: (419) 227-7117
Get Directions

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
1	363AM0700X	Physician Assistant	Medical	50.004109	OHIO	Yes

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
1	0105065	OTHER	OHIO	MEDICAID GROUP
2	9943723	OTHER	OHIO	MEDICARE GROUP PTAN
3	34-1689161	OTHER	OHIO	GROUP TIN
4	1184652539	OTHER	OHIO	GROUP NPI
5	0116351	MEDICAID	OHIO

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: 4/28/2024

NPI Synchronization or Removal

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