Lundberg Medical Imaging PSC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

LUNDBERG MEDICAL IMAGING PSC

Practice address

2421 Broadway St
Paducah, KY 42001-7115

Phone

(270) 442-8272

Fax

(270) 444-0539

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gershom Lundberg

Title

Owner

Phone

(270) 442-8272

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1336229947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017115",
            "telephone_number": "270-442-8272",
            "fax_number": "270-444-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017115",
            "telephone_number": "270-442-8272",
            "fax_number": "270-444-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNDBERG MEDICAL IMAGING PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "LUNDBERG",
        "authorized_official_first_name": "GERSHOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-442-8272",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4932",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100152590",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA #",
            "identifier": "150821",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTIN",
            "identifier": "2398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA NUMBER",
            "identifier": "150821",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drew Joshua Lucas, M.S.
• Amy E Lui, OTR/L
• Stephen W Luigs, MD
• Cassidy E Luker
• Lindsey Jo Lund, MD
• Gershom Lundberg, M.D
• Luxottica of America Inc.
• Tara L Lykins, CNS
• Walter Scott Lykins, M.D.
• Jessica Lynn Lynch

• Diagnostic Radiology Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Diagnostic Radiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.