Provider Demographics
NPI:1407836729
Name:BARKE, LORA (DO)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:BARKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:501 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2702
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS15792085R0202X
IL0361006702085R0202X
NE6552085R0202X
KS05-365322085R0202X
CO451782085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200423660AMedicaid
WA0324192Medicaid
MN1407836729Medicaid
NE84-059792913Medicaid
IL036100670Medicaid
WY124182600Medicaid
NV1407836729Medicaid
AZ032646Medicaid
NE10025709000Medicaid
IA1407836729Medicaid
CA1407836729Medicaid
NEP00720359OtherRR MCR NE
CO10279873Medicaid
OK200505370AMedicaid
NM73076325Medicaid
NENA2517018Medicare PIN
NE10025709000Medicaid
MN1407836729Medicaid
NE84-059792913Medicaid
NV1407836729Medicaid
KS111257002Medicare PIN
NENA1215014Medicare PIN
NENA1214014Medicare PIN
COCO303830Medicare PIN