Individual provider Active NPI

Lynn R Webster, M.D.

  • Pain Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1164420246
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
161058-1205 Issued in UT
Practice address
3838 S 700 E
Ste 200
Salt Lake City, UT 84106-1466
Phone
(801) 261-4988
Fax
(801) 269-9427
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 161058-1205 UT
Pain Medicine Physician 208VP0000X 161058-1205 UT Primary

Addresses

Primary practice location

3838 S 700 E
Ste 200
Salt Lake City, UT 84106-1466

Mailing address

PO Box 27688
Salt Lake City, UT 84127-0688
Phone (801) 534-1360

Other identifiers 1

IdentifierTypeStateIssuer
05657MedicaidUT

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
161058-1205UTMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetree Medical Inc Pain Medicine PastSince Jul 1, 2001 Accepting new patients
Omega Interventional Pain PLLC Pain Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1164420246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27688",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270688",
            "telephone_number": "801-534-1360",
            "fax_number": "801-366-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 S 700 E",
            "address_2": "STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061466",
            "telephone_number": "801-261-4988",
            "fax_number": "801-269-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "LYNN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "161058-1205",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "UT",
            "license": "161058-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05657",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.