Active NPI
Stephanie C Lynch, M.D.
- Pediatrics Physician
- Louisville, KY
National Provider Identifier
1295718005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 39239
- Practice address
- 4171 Westport Rd
Louisville, KY 40207-2739 - Phone
- (502) 896-8868
- NPI assigned
- Nov 25, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 39239 | KY | Primary |
Addresses
Primary practice location
4171 Westport Rd
Louisville, KY 40207-2739
Mailing address
4171 Westport Rd
Louisville, KY 40207-2739
Phone (502) 896-8868
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000356008 | Other | KY | BLUE SHIELD |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39239 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Louisville Pediatrics, P.S.C. | Pediatrics | Current | Accepting new patients |
| One Pediatrics, PLLC | Pediatrics | Past | Accepting new patients |
Locations
6112 Crestwood Sta
Crestwood, KY 40014
4171 Westport Rd
Louisville, KY 40207
Phone (502) 895-6702
Organizations & group practices 2
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": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1295718005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4171 WESTPORT RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402072739",
"telephone_number": "502-896-8868",
"fax_number": "502-895-6278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4171 WESTPORT RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402072739",
"telephone_number": "502-896-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "STEPHANIE",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-25",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "39239",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000000356008",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.