Basic Information
Provider Information | |||||||||
NPI: | 1811222367 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BARGER | ||||||||
FirstName: | KATIE | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3520 SW 6TH AVE | ||||||||
Address2: |   | ||||||||
City: | TOPEKA | ||||||||
State: | KS | ||||||||
PostalCode: | 666062806 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7853549591 | ||||||||
FaxNumber: | 7853540591 | ||||||||
Practice Location | |||||||||
Address1: | 3520 SW 6TH AVE | ||||||||
Address2: |   | ||||||||
City: | TOPEKA | ||||||||
State: | KS | ||||||||
PostalCode: | 666062806 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7853549591 | ||||||||
FaxNumber: | 7853540591 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/15/2009 | ||||||||
LastUpdateDate: | 10/23/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | R71579 | AZ | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 2080P0205X | 04-38148 | KS | Y |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology |
ID Information
ID | Type | State | Issuer | Description | 068002309 | 01 | KS | MEDICARE PTAN | OTHER | 201117920A | 05 | KS |   | MEDICAID |