BROOKE A LANGE (NPI# 1093103038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093103038 |
| Entity Type | Individual |
| Full Name | BROOKE A LANGE |
| Credential | PA-C |
| Practice Address |
830 W High St Ste 360 Lima OH 45801-3985 |
| Mailing Address |
Po Box 636930 Cincinnati OH 45263-6930 |
| Practice Telephone | 4192277117 |
| Practice Fax Number | 4192272848 |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2020-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
50.004109 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | MEDICAID GROUP | 0105065 | 01 |
| OH | MEDICARE GROUP PTAN | 9943723 | 01 |
| OH | GROUP NPI | 1184652539 | 01 |
| OH | 0116351 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477105534 | Brooke Lange | Occupational Therapist | 209 Ash St E, Annandale, MN 55302-3148 | 2019-07-09 |
| 1346535721 | Brooke Lange | Counselor | 660 S 200 E, Suite 308, Salt Lake City, UT 84111-3835 | 2011-06-14 |
| Street Address |
830 W HIGH ST STE 360 |
| City | LIMA |
| State | OH |
| Zip Code | 45801-3985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649598004 | Anne R Edgerton | Surgery | 830 W High St Ste 360, Lima, OH 45801-3985 | 2010-05-11 |
| 1033760244 | Cameron Pappa | Physician Assistant | 830 W High St Ste 360, Lima, OH 45801-3985 | 2019-09-28 |
| 1689133308 | Calib Cox | Physician Assistant | 830 W High St Ste 360, Lima, OH 45801-3985 | 2019-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053839720 | Candie Sue Dray | Counselor | 311 Market St., 311 Market St, Lima, OH 45801 | 2017-09-01 |
| 1962945105 | Alisha Harper | Social Worker | 200 E. High St. 2nd Floor, Lima, OH 45801 | 2016-11-21 |
| 1841740156 | Bullock Home Care | Home Health | 128 West High Street, Lima, OH 45801 | 2016-10-11 |
| 1952787707 | Brenda Tran Hoang | Pharmacist | 730 W Market St., Lima, OH 45801 | 2015-08-04 |
| 1134511918 | Gbenga Balogun | Registered Nurse | 1225 Summit Street, Lima, OH 45801 | 2015-03-03 |
| 1588802763 | Illness Prevention and Holistic Health Center | Specialist | 545 West Market Street, Suite 306, Lima, OH 45801 | 2009-01-27 |
| 1033302237 | Custom Staffing Lima Inc | Home Health | 712 W North St, Lima, OH 45801 | 2007-08-21 |
| 1316167463 | Ear Nose and Throat Specialists of West Central Ohio | Otolaryngology | 770 West High St, Suite 480, Lima, OH 45801 | 2007-04-30 |
| 1598886566 | Zita Marie Duffy | Social Worker | 658 W Market St Ste 101, Lima, OH 45801 | 2007-04-03 |
| 1487787875 | Steve C Knapke | Specialist/Technologist | 730 West Market St., Lima, OH 45801 | 2007-03-14 |
| Find all providers in zip 45801 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104259985 | Christina D Hagerty | Physician Assistant | 770 West Hight Street, Ste 300, Lima, OH 45801-3971 | 2013-08-15 |
| 1447258983 | Cheryl L Kern-buell | Physician Assistant | 770 W High St Ste 350, Lima, OH 45801-5901 | 2005-07-08 |
| 1730722133 | Jessica M Schierloh | Physician Assistant | 1001 Bellefontaine Ave, Lima, OH 45804-2800 | 2019-10-18 |
| 1083266902 | Emily K Recker | Physician Assistant | 1003 Bellefontaine Ave Ste 200, Lima, OH 45804-2868 | 2019-07-11 |
| 1144768383 | Cody Jones | Physician Assistant | 1001 Bellefontaine Ave, Lima, OH 45804-2800 | 2017-02-08 |
| 1962850479 | Danielle Lutton | Physician Assistant | 730 W Market St, Lima, OH 45801-4602 | 2016-05-25 |
| 1043648868 | Jamie Chaffee | Physician Assistant | 730 W Market St, Lima, OH 45801-4602 | 2013-10-15 |
| 1326370115 | Jill M Kuhlman | Physician Assistant | 2740 W Market St, Lima, OH 45805-2120 | 2010-02-04 |
| 1700010014 | Christopher D Frick | Physician Assistant | 1003 Bellefontaine Ave Ste 200, Lima, OH 45804-1803 | 2009-05-14 |
| 1073623096 | Rosemary P Pinto-chung | Physician Assistant | 1220 E Elm St, Suite 204, Lima, OH 45804-2850 | 2006-08-30 |
| Find all providers in LIMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.