Lynn Fairchild, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001687 Issued in CT

Practice address

47 Jolley Dr
Bloomfield, CT 06002-3092

Phone

(860) 243-3020

Fax

(860) 243-3002

NPI assigned

Mar 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lynn Michelle Fairchild Professional name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jennifer W Pennoyer MD LLCGroup PAC ID 4789605023, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Jennifer W Pennoyer MD LLC

  • Dermatology Physician
  • Bloomfield, CT
  • NPI 1841254653
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1366403107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 JOLLEY DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023092",
            "telephone_number": "860-243-3020",
            "fax_number": "860-243-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 JOLLEY DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023092",
            "telephone_number": "860-243-3020",
            "fax_number": "860-243-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "FAIRCHILD",
            "middle_name": "MICHELLE",
            "credential": "PAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Cheryl Ellis, PSYD
• Erin & Holly II LLC
• Elizabeth Yvonne Evans, M.D.
• Family Dental Practice of Bloomfield
• Family Life Lifters, Inc.
• Family Optometric Care PC
• Julie Jason Farrelly
• Maureen Elizabeth Fearon, APRN

• Physician Assistant in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.