Individual provider Active NPI

Michael Edward Lynch Sr., MD

  • Obstetrics & Gynecology Physician
  • Jasper, GA
National Provider Identifier
1073519013
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
40146 Issued in GA
Practice address
220 J L White Dr Ste 120
Jasper, GA 30143-4894
Phone
(706) 692-3539
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 40146 GA Primary

Addresses

Primary practice location

220 J L White Dr Ste 120
Jasper, GA 30143-4894

Mailing address

204 E 15TH St
Alma, GA 31510-2908
Phone (912) 632-2952

Other practice location 1

3345 US Highway 84 Ste 100
Blackshear, GA 31516-2160
Phone (912) 632-2952

Other practice location 2

204 E 15th St
Alma, GA 31510-2908
Phone (912) 632-2952

Other practice location 3

1406 Habersham Dr
Waycross, GA 31501-5306
Phone (912) 287-1130

Other identifiers 1

IdentifierTypeStateIssuer
000791612MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050316000714 GA Practitioner - Obstetrics/Gynecology 7911952775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Mercer University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

1266 Hwy 515 S
Jasper, GA 30143-4872
Phone (706) 692-2441

Hospital & facility affiliations

  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40146GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC CurrentSince Dec 5, 2022 Accepting new patients
Piedmont Mountainside Hospital, Inc. Past Accepting new patients
Michael E Lynch Sr MD PC Past Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

220 J L White Dr
Ste 120
Jasper, GA 30143
Phone (706) 692-3539

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

Interoperability endpoints

  • Direct secure messaging: michael.lynch@bacon.gadirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1073519013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 15TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102908",
            "telephone_number": "912-632-2952",
            "fax_number": "912-632-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 J L WHITE DR STE 120",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434894",
            "telephone_number": "706-692-3539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3345 US Highway 84 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Blackshear",
            "state": "GA",
            "postal_code": "315162160",
            "country_code": "US",
            "telephone_number": "912-632-2952",
            "fax_number": "912-632-8682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 E 15th St",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "GA",
            "postal_code": "315102908",
            "country_code": "US",
            "telephone_number": "912-632-2952",
            "fax_number": "912-632-8682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1406 Habersham Dr",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315015306",
            "country_code": "US",
            "telephone_number": "912-287-1130",
            "fax_number": "912-287-9114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "40146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000791612",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.