Organization Active NPI

Bryan G Baer, MD, Prof LLC

  • Specialist
  • Wheat Ridge, CO
National Provider Identifier
1508055237
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28172 Issued in CO
Legal business name
BRYAN G BAER, MD, PROF LLC
Practice address
8550 W 38TH Ave
Ste 205
Wheat Ridge, CO 80033-4300
Phone
(303) 467-8991
Fax
(303) 467-9510
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. Bryan Gordon Baer, MDNPI 1912904327
Title
Owner
Phone
(303) 467-8991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 28172 CO Primary

Addresses

Primary practice location

8550 W 38TH Ave
Ste 205
Wheat Ridge, CO 80033-4300

Mailing address

8550 W 38TH Ave
Ste 205
Wheat Ridge, CO 80033-4300
Phone (303) 467-8991

Other identifiers 1

IdentifierTypeStateIssuer
39023389MedicaidCO

National Provider Directory

National Provider Directory

Locations

8550 W 38th Ave
Ste 205
Wheat Ridge, CO 80033
Phone (303) 425-2797

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1508055237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE",
            "address_2": "STE 205",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334300",
            "telephone_number": "303-467-8991",
            "fax_number": "303-467-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 W 38TH AVE",
            "address_2": "STE 205",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800334300",
            "telephone_number": "303-467-8991",
            "fax_number": "303-467-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN G BAER, MD, PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "BAER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-467-8991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CO",
            "license": "28172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39023389",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.