Individual provider Active NPI

Jake C Lennard, M.D.

  • Gastroenterology Physician
  • Amarillo, TX
National Provider Identifier
1104869536
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G2422 Issued in TX
Practice address
6700 W 9TH Ave
Amarillo, TX 79106-1729
Phone
(806) 358-0200
Fax
(806) 356-5511
NPI assigned
Jun 14, 2006
Last updated
Mar 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G2422 TX Primary

Addresses

Primary practice location

6700 W 9TH Ave
Amarillo, TX 79106-1729

Mailing address

6700 W 9TH Ave
Amarillo, TX 79106-1729
Phone (806) 358-0200

Other identifiers 1

IdentifierTypeStateIssuer
100664503MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G2422TXMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1104869536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061729",
            "telephone_number": "806-358-0200",
            "fax_number": "806-356-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061729",
            "telephone_number": "806-358-0200",
            "fax_number": "806-356-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNARD",
        "first_name": "JAKE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "G2422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100664503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.