Individual provider Active NPI

Justin Thomas Lelbach, L.M.P

  • Specialist
  • Spokane, WA
National Provider Identifier
1356618532
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60197157 Issued in WA
Practice address
2408 E Wellesley Ave
Spokane, WA 99217-5966
Phone
(509) 270-2387
NPI assigned
Nov 16, 2011
Last updated
Nov 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60197157 WA Primary

Addresses

Primary practice location

2408 E Wellesley Ave
Spokane, WA 99217-5966

Mailing address

2408 E Wellesley Ave
Spokane, WA 99217-5966
Phone (509) 270-2387

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

State licenses

LicenseStateTypeSpecialty
MA60197157WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1356618532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 E WELLESLEY AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992175966",
            "telephone_number": "509-270-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 E WELLESLEY AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992175966",
            "telephone_number": "509-270-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELBACH",
        "first_name": "JUSTIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "L.M.P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60197157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.