Justin Ray Lancaster, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

5301 Bainbridge Ave
Gulfport, MS 39501-9026

Phone

(228) 871-4158

NPI assigned

May 11, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1073831376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 OVERLAND TRL",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784101857",
            "telephone_number": "619-379-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 BAINBRIDGE AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395019026",
            "telephone_number": "228-871-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "JUSTIN",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• An N Lam
• Kacee Lambe, NP
• Bobby Lambert, CSFA
• Laurin Alexandra Lambert
• Clinton Paul Lamey, NP
• Danielle Landers, DPT
• Hope Landis, N.P.
• Landmark Medical of Mississippi PC
• Thomas Edward Landon Jr., N.P.
• Kianna Jeanette Lane

• Independent Duty Corpsman in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Independent Duty Corpsman in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.