Individual provider Active NPI

George W. Luedke, M.D.

  • Psychiatry Physician
  • Lynchburg, VA
National Provider Identifier
1194719641
Registry record updated Apr 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101031815 Issued in VA
Practice address
1049 Claymont Dr
Lynchburg, VA 24502-4481
Phone
(434) 582-1600
Fax
(434) 582-4807
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 0101031815 VA
Forensic Psychiatry Physician 2084F0202X 0101031815 VA
Psychiatry Physician 2084P0800X 0101031815 VA Primary

Addresses

Primary practice location

1049 Claymont Dr
Lynchburg, VA 24502-4481

Mailing address

1048 Terrace Dr
Marion, VA 24354-4138
Phone (276) 783-1827

Other identifiers 7

IdentifierTypeStateIssuer
186467OtherANTHEM PROVIDER NUMBER
001238OtherVALUE OPTIONS PROVIDER NU
84228MOtherSENTARA/OPTIMA PROVIDER N
20-3639329OtherPCHP PROVIDER NUMBER
203639329001OtherTRICARE PROVIDER NUMBER
70985OtherCIGNA BEHAVIOR PROVIDER N
010220751MedicaidVA

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
0101031815VAMDPsychiatry Physician

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20303/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1194719641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 TERRACE DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544138",
            "telephone_number": "276-783-1827",
            "fax_number": "276-783-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 CLAYMONT DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024481",
            "telephone_number": "434-582-1600",
            "fax_number": "434-582-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDKE",
        "first_name": "GEORGE",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "VA",
            "license": "0101031815",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "VA",
            "license": "0101031815",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101031815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "186467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER NU",
            "identifier": "001238",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA PROVIDER N",
            "identifier": "84228M",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCHP PROVIDER NUMBER",
            "identifier": "20-3639329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER NUMBER",
            "identifier": "203639329001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIOR PROVIDER N",
            "identifier": "70985",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010220751",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.