Individual provider Active NPI

Colby Joel Barker

  • Physician Assistant
  • Ocala, FL
National Provider Identifier
1104395144
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111726 Issued in FL
Practice address
3415 E Silver Springs Blvd
Ocala, FL 34470-6405
Phone
(352) 629-7336
NPI assigned
Nov 20, 2018
Last updated
Oct 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111726 FL Primary

Addresses

Primary practice location

3415 E Silver Springs Blvd
Ocala, FL 34470-6405

Mailing address

PO Box 2066
Lecanto, FL 34460-2066
Phone (352) 563-0931

Other identifiers 1

IdentifierTypeStateIssuer
101487900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@quickcaremed.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181211002348 FL Practitioner - Physician Assistant 8820332224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9111726FLMDPhysician Assistant

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1104395144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2066",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344602066",
            "telephone_number": "352-563-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 E SILVER SPRINGS BLVD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344706405",
            "telephone_number": "352-629-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "COLBY",
        "middle_name": "JOEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-20",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101487900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@quickcaremed.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3415 E Silver Springs Blvd",
            "city": "Ocala",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344706405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.