Individual provider Active NPI

Willert Howard Lynn III, MD

  • Family Medicine Physician
  • Rincon, GA
National Provider Identifier
1174509145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
GA 47979 Issued in GA
Practice address
800 Towne Park Dr
Suite 400
Rincon, GA 31326-5156
Phone
(912) 826-1220
Fax
(912) 826-1216
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X GA 47979 GA Primary

Addresses

Primary practice location

800 Towne Park Dr
Suite 400
Rincon, GA 31326-5156

Mailing address

PO Box 2055
Rincon, GA 31326-2055
Phone (912) 826-1220

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
I20060821000073 GA Practitioner - Family Practice 9830141944 Reassigns benefits to 1 organization
Practice locations: Rincon, GA

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

802 Towne Park Dr
Rincon, GA 31326-5151

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Savannah, GA, CCN 117078
  • Effingham Health System Hospital, Springfield, GA, CCN 111306
  • Candler Hospital Hospital, Savannah, GA, CCN 110024
  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
76.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47479GAMDEmergency Medical Services (Emergency Medicine) Physician
GA 47979GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn'S Family Practice, PC Family Medicine CurrentSince Aug 14, 2006 Accepting new patients
Effingham Hospital, Inc. PastSince Jun 8, 2025 Accepting new patients

Locations

802 Towne Park Dr
Rincon, GA 31326
Phone (912) 303-9355

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.

Hospital & facility affiliations 4

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174509145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2055",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313262055",
            "telephone_number": "912-826-1220",
            "fax_number": "912-826-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TOWNE PARK DR",
            "address_2": "SUITE 400",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265156",
            "telephone_number": "912-826-1220",
            "fax_number": "912-826-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "WILLERT",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "GA 47979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

Verify at the official NPI Registry.