Individual provider Active NPI

Lynne Lanham

  • Primary Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1285227728
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
3015460 Issued in KY
Practice address
2133 W Market St
Louisville, KY 40212-1532
Phone
(502) 384-5807
NPI assigned
Feb 16, 2021
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 3015460 KY Primary

Addresses

Primary practice location

2133 W Market St
Louisville, KY 40212-1532

Mailing address

17004 Epson CT
Louisville, KY 40245-4483
Phone (502) 608-6185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422001533 KY Practitioner - Nurse Practitioner 3274058367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Clark Medical Group LLCGroup PAC ID 3971879354, 21 clinicians

Practice addresses (Care Compare)

2001 W Broadway
Suite 4 and 13
Louisville, KY 40203-3595
Phone (502) 276-1273

645 S Roy Wilkins Ave
Suite 200
Louisville, KY 40203-2072
Phone (502) 244-9859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Resource Services Inc Public Health and Wellness Center CurrentSince Jan 1, 2025 Accepting new patients
2022 LLC Past Accepting new patients
2022 LLC Primary Care Past Accepting new patients

Locations

2001 W Broadway
Ste 13
Louisville, KY 40203
Phone (502) 276-1273

2001 W Broadway
Ste 4
Louisville, KY 40203

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1285227728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17004 EPSON CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402454483",
            "telephone_number": "502-608-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2133 W MARKET ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402121532",
            "telephone_number": "502-384-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANHAM",
        "first_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3015460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.