Active NPI
Patrick Barde Lang, PA-C
- Physician Assistant
- Midvale, UT
National Provider Identifier
1285794552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 7495 South. State Street
Midvale, UT 84047 - Phone
- (801) 213-9400
- NPI assigned
- Dec 9, 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 | UT | Primary |
Addresses
Primary practice location
7495 South. State Street
Midvale, UT 84047
Mailing address
7495 South. State Street
Midvale, UT 84047
Phone (801) 213-9400
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 377086-8906 | Other | UT | UTAH DOPL PA CONTROL SUB |
| TPRA08420 | Other | UT | MOLINDA HEALTHCARE OF UT |
| 377086-1206 | Other | UT | UT DPOL PA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1285794552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7495 SOUTH. STATE STREET",
"city": "MIDVALE",
"state": "UT",
"postal_code": "84047",
"telephone_number": "801-213-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7495 SOUTH. STATE STREET",
"city": "MIDVALE",
"state": "UT",
"postal_code": "84047",
"telephone_number": "801-213-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "PATRICK",
"middle_name": "BARDE",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-09",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DOPL PA CONTROL SUB",
"identifier": "377086-8906",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINDA HEALTHCARE OF UT",
"identifier": "TPRA08420",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UT DPOL PA",
"identifier": "377086-1206",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midvale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.