Active NPI
Kevin Jay Lythgoe, M.D.
- Obstetrics & Gynecology Physician
- Phoenix, AZ
National Provider Identifier
1295727253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 21855
- Practice address
- 530 E Thomas Rd
Phoenix, AZ 85012-3204 - Phone
- (602) 351-2229
- Fax
- (602) 351-1500
- NPI assigned
- Aug 16, 2005
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 21855 | AZ | Primary |
Addresses
Primary practice location
530 E Thomas Rd
Phoenix, AZ 85012-3204
Mailing address
1661 E Camelback Rd Ste 205
Phoenix, AZ 85016-3913
Phone (602) 422-9000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 860966838 | Other | AZ | TAX ID |
| AZ0860720 | Other | AZ | BLUE CROSS BLUE SHIELD |
| 198433 | Medicaid | AZ | |
| 3372334 | Other | AZ | CIGNA |
| 1Z1309 | Other | AZ | HEALTH NET |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21855 | AZ | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1295727253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1661 E CAMELBACK RD STE 205",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850163913",
"telephone_number": "602-422-9000",
"fax_number": "602-556-5951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850123204",
"telephone_number": "602-351-2229",
"fax_number": "602-351-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYTHGOE",
"first_name": "KEVIN",
"middle_name": "JAY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2021-01-26",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "AZ",
"license": "21855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "860966838",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0860720",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "198433",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3372334",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "1Z1309",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.