Basic Information
Provider Information
NPI: 1942652235
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAUER
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BAUER
OtherFirstName: JAMES
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA
OtherLastNameType: 2
Mailing Information
Address1: PO BOX 172328
Address2:  
City: DENVER
State: CO
PostalCode: 802172328
CountryCode: US
TelephoneNumber: 3033067783
FaxNumber: 3033067753
Practice Location
Address1: 10101 RIDGEGATE PKWY
Address2:  
City: LONE TREE
State: CO
PostalCode: 801245522
CountryCode: US
TelephoneNumber: 7202251000
FaxNumber: 7202251969
Other Information
ProviderEnumerationDate: 07/11/2016
LastUpdateDate: 09/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XPA.0005348COY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
207P00000XPA.0005348CON Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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