Active NPI
Jackson Family Medical PLLC
- Geriatric Medicine (Family Medicine) Physician
- Jackson, MI
National Provider Identifier
1013167444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- Legal business name
- JACKSON FAMILY MEDICAL PLLC
- Practice address
- 724 W Franklin St
Jackson, MI 49201-2008 - Phone
- (517) 784-3100
- Fax
- (517) 784-3200
- NPI assigned
- Sep 22, 2008
- Last updated
- Jul 19, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gary Laverne Lynd, D.O.
- Title
- Owner/Physician
- Phone
- (517) 784-3100
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | NU | Primary |
Addresses
Primary practice location
724 W Franklin St
Jackson, MI 49201-2008
Mailing address
724 W Franklin St
Jackson, MI 49201-2008
Phone (517) 784-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Jackson Family Medical
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Physician
- Jackson, MI
- NPI 1972873800
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Jackson, MI
- NPI 1235127184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222041600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1342656000000",
"number": "1013167444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "724 W FRANKLIN ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012008",
"telephone_number": "517-784-3100",
"fax_number": "517-784-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 W FRANKLIN ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012008",
"telephone_number": "517-784-3100",
"fax_number": "517-784-3200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON FAMILY MEDICAL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-22",
"last_updated": "2012-07-19",
"status": "A",
"authorized_official_last_name": "LYND",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "LAVERNE",
"authorized_official_title_or_position": "OWNER/PHYSICIAN",
"authorized_official_telephone_number": "517-784-3100",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.