Active NPI
Justin Ryan Lynn, RPH
- Pharmacist
- Muskogee, OK
National Provider Identifier
1235655572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17539
- Practice address
- 1011 Honor Heights Dr
Muskogee, OK 74401-1318 - Phone
- (405) 818-0486
- NPI assigned
- Aug 18, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17539 | OK | Primary |
Addresses
Primary practice location
1011 Honor Heights Dr
Muskogee, OK 74401-1318
Mailing address
14217 SW 74TH St
Mustang, OK 73064-9595
Phone (405) 818-0486
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17539 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503014400000",
"number": "1235655572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14217 SW 74TH ST",
"city": "MUSTANG",
"state": "OK",
"postal_code": "730649595",
"telephone_number": "405-818-0486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 HONOR HEIGHTS DR",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744011318",
"telephone_number": "405-818-0486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNN",
"first_name": "JUSTIN",
"middle_name": "RYAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-18",
"last_updated": "2017-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "17539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.