Individual provider Active NPI

Karlyn Gremore Lynch, RDN

  • Registered Dietitian
  • Indianapolis, IN
National Provider Identifier
1295341683
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
37001742A Issued in IN
Practice address
7240 Shadeland Sta Ste 200
Indianapolis, IN 46256-3968
Phone
(317) 621-2677
Fax
(317) 621-2676
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 927597 IN
Registered Dietitian 133V00000X 37001742A IN Primary

Addresses

Primary practice location

7240 Shadeland Sta Ste 200
Indianapolis, IN 46256-3968

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

8101 Clearvista Pkwy Ste 200
Indianapolis, IN 46256-4675
Phone (317) 621-4502

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230518001307 IN Practitioner - Registered Dietitian Or Nutrition Professional 8921464876 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
927597INMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Apr 17, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Apr 17, 2023 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7240 Shadeland Sta
Ste 200
Indianapolis, IN 46256
Phone (317) 621-2677

8101 Clearvista Pkwy
Ste 200
Indianapolis, IN 46256
Phone (317) 621-5390

Organizations & group practices 3

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1295341683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 SHADELAND STA STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563968",
            "telephone_number": "317-621-2677",
            "fax_number": "317-621-2676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 Clearvista Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462564675",
            "country_code": "US",
            "telephone_number": "317-621-4502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "KARLYN",
        "middle_name": "GREMORE",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "927597",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IN",
            "license": "37001742A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.