Active NPI
David P Lange, MD
- Emergency Medicine Physician
- Fruita, CO
National Provider Identifier
1740361401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DR.0051636
- Practice address
- 300 W Ottley Ave
Fruita, CO 81521-2118 - Phone
- (970) 858-3900
- Fax
- (970) 858-2743
- NPI assigned
- Oct 18, 2006
- Last updated
- Jan 7, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D64974 | MD | |
| Hospitalist Physician | 208M00000X | D64974 | MD | |
| Emergency Medicine Physician | 207P00000X | DR.0051636 | CO | Primary |
Addresses
Primary practice location
300 W Ottley Ave
Fruita, CO 81521-2118
Mailing address
PO Box 130
Fruita, CO 81521-0130
Phone (970) 858-2186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 279281800 | Medicaid | MD |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR.0051636 | CO | MD | Emergency Medicine Physician |
| D64974 | MD | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546819200000",
"number": "1740361401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"city": "FRUITA",
"state": "CO",
"postal_code": "815210130",
"telephone_number": "970-858-2186",
"fax_number": "970-858-2208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W OTTLEY AVE",
"city": "FRUITA",
"state": "CO",
"postal_code": "815212118",
"telephone_number": "970-858-3900",
"fax_number": "970-858-2743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "DAVID",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2019-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D64974",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MD",
"license": "D64974",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "DR.0051636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "279281800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fruita, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.