MR. CARL W LANGE IV (NPI# 1700200458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700200458 |
| Entity Type | Individual |
| Full Name | MR. CARL W LANGE IV |
| Other Name | MR. CHIP LANGE IV |
| Credential | PA |
| Practice Address |
1337 S Sam Houston Blvd Houston MO 65483-2046 |
| Practice Telephone | 4179675435 |
| Practice Fax Number | 4179675503 |
| Mailing Telephone | 4179675435 |
| Mailing Fax Number | 4179675503 |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2014004500 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1700200458 | 05 | |
| MO | CLIA | 26D0889777 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093211252 | Carl Anthony Lange Jr. | Specialist/Technologist | 424 W Collings Ave, Collingswood, NJ 08108-3054 | 2018-04-04 |
| 1417907569 | Carl Lange | Emergency Medicine | 2 Hot Metal St, Ermi Quantum One, Pittsburgh, PA 15203-2348 | 2006-05-11 |
| Street Address |
1337 S SAM HOUSTON BLVD |
| City | HOUSTON |
| State | MO |
| Zip Code | 65483-2046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164483921 | Christopher O Baldwin | Obstetrics & Gynecology | 1337 S Sam Houston Blvd, Houston, MO 65483 | 2006-03-31 |
| 1538717871 | Tommi Jean Alcorn | Registered Nurse | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2019-08-29 |
| 1760834378 | Sheena Caitlyn Painter | Nurse Practitioner | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2016-07-07 |
| 1760862551 | Holly Noel Atterberry | Nurse Practitioner | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2015-06-05 |
| 1730527318 | Teresa Lorraine Loden | Pediatrics | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2013-06-05 |
| 1407160641 | Gretchen E Price | Internal Medicine | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2010-07-29 |
| 1477783686 | Jonathan Robert Beers | Internal Medicine | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2009-07-22 |
| 1174779300 | Matthew Austin Brown | Family Medicine | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2008-08-07 |
| 1710004486 | Texas County Memorial Hospital | Clinic/Center | 1337 S Sam Houston Blvd, Suite 200, Houston, MO 65483-2046 | 2007-03-26 |
| 1942359005 | Patricia A Benoist | Family Medicine | 1337 S Sam Houston Blvd, Houston, MO 65483-2046 | 2007-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
| 1942657606 | Community Counseling Services of Missouri, L.L.C. | Counselor | 1591 C North Highway 63, Houston, MO 65483 | 2016-05-23 |
| 1083081681 | Vicky Birdsong | Registered Nurse | 1597 North Hwy 63, Houston, MO 65483 | 2015-08-31 |
| 1578794525 | Mary Jane Lybyer | Speech-Language Pathologist | 423 W. Pine, Houston, MO 65483 | 2009-08-06 |
| 1851530257 | Womack Chiropractic Center, PC | Chiropractor | 118 W. Main St., Houston, MO 65483 | 2009-02-10 |
| 1588793459 | Houston R-1 School District | Local Education Agency (LEA) | 204 W. Spruce, Houston, MO 65483 | 2007-03-05 |
| 1487783296 | Mercy Clinic-springfield Communities | Family Medicine | 1422 S Sam Houston Blvd, Houston, MO 65483 | 2007-03-05 |
| 1164587770 | Texas County Memorial Hospital | Pharmacy | 1422 S Sam Houston Blvd Ste 100, Houston, MO 65483 | 2006-12-26 |
| 1336226513 | Deborah Belt-kell | Counselor | Tcmh Annex - Mental Health, 1333 S Sam Houston Blvd, Houston, MO 65483 | 2006-11-01 |
| 1356324727 | Texas County Memorial Hospital | Home Health | 1422 S Sam Houston Blvd Ste 200, Houston, MO 65483 | 2005-11-21 |
| Find all providers in zip 65483 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345443 | Avery Rhodes Schwartz | Physician Assistant | 2206 Latexo Dr, Houston, TX 77018-1717 | 2020-10-28 |
| 1881291938 | Christine Nicole Nott | Physician Assistant | 13325 Hargrave Rd # 240, Houston, TX 77070-4539 | 2020-10-01 |
| 1306453659 | Christine Michelle Serewis - Pond | Physician Assistant | 950 Threadneedle St # 282, Houston, TX 77079-2925 | 2020-09-29 |
| 1902412828 | Chen-ho Yang | Physician Assistant | 1818 Memorial Dr Ste 200, Houston, TX 77007-8383 | 2020-09-16 |
| 1437769833 | Aviva Tziporah Rogozen | Physician Assistant | 4550 N Braeswood Blvd Apt 331, Houston, TX 77096-2883 | 2020-07-31 |
| 1417575671 | Harmeet Kaur | Physician Assistant | 9601 Jones Rd Ste 238, Houston, TX 77065-4774 | 2020-07-13 |
| 1780201939 | Evelyn Oliva | Physician Assistant | 4943 Brenner St, Houston, TX 77022-2536 | 2020-07-02 |
| 1093330722 | Stephanie Kochuparambil | Physician Assistant | 2630 Bissonnet St Apt 5213, Houston, TX 77005-1571 | 2020-06-09 |
| 1376171587 | Samad Syed Ali | Physician Assistant | 12702 Morning Glory Meadow Ln, Houston, TX 77089-1551 | 2020-04-01 |
| 1235765660 | Samantha Salcedo | Physician Assistant | 6651 Main St Ste 1420, Houston, TX 77030-2351 | 2020-03-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.