Individual provider Active NPI

Keith Patrick Lynch, D.C.

  • Chiropractor
  • Charlottesville, VA
National Provider Identifier
1245447747
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104 001987 Issued in VA
Practice address
1410 Incarnation Dr Ste 202C
Charlottesville, VA 22901-5708
Phone
(434) 245-8456
Fax
(434) 245-8457
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104 001987 VA Primary

Addresses

Primary practice location

1410 Incarnation Dr Ste 202C
Charlottesville, VA 22901-5708

Mailing address

136 Buffalo Run Rd
Stanardsville, VA 22973-3659
Phone (434) 985-6094

Other identifiers 1

IdentifierTypeStateIssuer
180813OtherVAANTHEM BLUE CROSS AND BLU

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090320000087 VA Practitioner - Chiropractic 0547230302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1410 Incarnation Dr
Suite 202C
Charlottesville, VA 22901-5708
Phone (434) 245-8456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104 001987VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lynch Clinic of Chiropractic, P.C. Chiropractor CurrentSince Aug 1, 2000 Accepting new patients

Locations

1410 Incarnation Dr
Ste 202C
Charlottesvle, VA 22901
Phone (434) 245-8456

Organizations & group practices 1

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1245447747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BUFFALO RUN RD",
            "city": "STANARDSVILLE",
            "state": "VA",
            "postal_code": "229733659",
            "telephone_number": "434-985-6094",
            "fax_number": "434-245-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 INCARNATION DR STE 202C",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229015708",
            "telephone_number": "434-245-8456",
            "fax_number": "434-245-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "KEITH",
        "middle_name": "PATRICK",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104 001987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS AND BLU",
            "identifier": "180813",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.