Judith Elaine Lynch, RD, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9105408 Issued in FL

Practice address

915 Nobles Ferry Rd
Live Oak, FL 32064-8463

Phone

(386) 364-1751

Fax

(386) 364-1761

NPI assigned

Jun 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Trenton Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Trenton, FL
  • NPI 1801826268
  Medicare reassignment
• Trenton Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Starke, FL
  • NPI 1912213000
  NPD
• Trenton Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fleming Island, FL
  • NPI 1275220238
  NPD
• Physicians Medical Center, Inc.

  • Rehabilitation Clinic/Center
  • Jacksonville, FL
  • NPI 1063454858
  NPD (past)

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1124221734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 US HIGHWAY 41 NW",
            "address_2": "SUITE 11 & 12",
            "city": "JASPER",
            "state": "FL",
            "postal_code": "320525888",
            "telephone_number": "386-792-7744",
            "fax_number": "386-792-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 NOBLES FERRY RD",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320648463",
            "telephone_number": "386-364-1751",
            "fax_number": "386-364-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "JUDITH",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "RD, PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-09",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9105408",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND5728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Livingston
• Loyal Passion Inc
• LP Live Oak LLC
• LT Pro Health Care Solutions
• Kathy Lumpkins
• James Dallas Malone
• Herbert C Mantooth, D.D.S.
• Gina R Marler, MED CCC SLP
• Vicente Manuel Martinez Cardenas, PNP-BC, ARNP
• Shellie Christina May, M.ED.

• Physician Assistant in Live Oak, FL
• Providers in Live Oak, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.