Active NPI
Deland Ray Barr, D.O.
- Family Medicine Physician
- Weiser, ID
National Provider Identifier
1316032261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0-116
- Practice address
- 683 E 3Rd St
Weiser, ID 83672-2248 - Phone
- (208) 549-0211
- Fax
- (208) 549-0104
- NPI assigned
- Oct 4, 2006
- Last updated
- Jun 3, 2009
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0-116 | ID | Primary |
Addresses
Primary practice location
683 E 3Rd St
Weiser, ID 83672-2248
Mailing address
PO Box 871
Weiser, ID 83672-0002
Phone (208) 549-3654
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004309900 | Medicaid | ID |
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0-116 | ID | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243987200000",
"number": "1316032261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 871",
"city": "WEISER",
"state": "ID",
"postal_code": "836720002",
"telephone_number": "208-549-3654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "683 E 3RD ST",
"city": "WEISER",
"state": "ID",
"postal_code": "836722248",
"telephone_number": "208-549-0211",
"fax_number": "208-549-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARR",
"first_name": "DELAND",
"middle_name": "RAY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2009-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "0-116",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004309900",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weiser, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.