Individual provider Active NPI

Norman Bates Farrar, DDS

  • Pediatric Dentistry
  • Colorado Springs, CO
National Provider Identifier
1669443693
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7257 Issued in CO
Practice address
2828 International Cir
Suite 100
Colorado Springs, CO 80910-3127
Phone
(719) 632-5700
NPI assigned
Jan 28, 2006
Last updated
Apr 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 7257 CO Primary

Addresses

Primary practice location

2828 International Cir
Suite 100
Colorado Springs, CO 80910-3127

Mailing address

3205 N Academy Blvd
Suite 130
Colorado Springs, CO 80917-5147
Phone (719) 632-5700

Other identifiers 1

IdentifierTypeStateIssuer
02072577MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150806011211 CO Order and Referring Only - DentistPractitioner - Dentist 4385958115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7257COMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Vista Community Health Centers Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1669443693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD",
            "address_2": "SUITE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175147",
            "telephone_number": "719-632-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 INTERNATIONAL CIR",
            "address_2": "SUITE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103127",
            "telephone_number": "719-632-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRAR",
        "first_name": "NORMAN",
        "middle_name": "BATES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "7257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02072577",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.