Active NPI
Richard A Barnes, PA-C
- Physician Assistant
- Traverse City, MI
National Provider Identifier
1164580676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003792
- Practice address
- 921 W Front St
Traverse City, MI 49684-2327 - Phone
- (231) 932-1039
- Fax
- (231) 995-3658
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003792 | MI | Primary |
Addresses
Primary practice location
921 W Front St
Traverse City, MI 49684-2327
Mailing address
921 W Front St
Traverse City, MI 49684-2327
Phone (231) 932-1039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003792 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1164580676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 W FRONT ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842327",
"telephone_number": "231-932-1039",
"fax_number": "231-995-3658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 W FRONT ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842327",
"telephone_number": "231-932-1039",
"fax_number": "231-995-3658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNES",
"first_name": "RICHARD",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.