Individual provider Active NPI

Justin Stryder Lyman, M.D.

  • Rheumatology Physician
  • Lake Charles, LA
National Provider Identifier
1376540393
Registry record updated Jan 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD.201804 Issued in LA
Practice address
608 W McNeese St
Lake Charles, LA 70605-5530
Phone
(337) 477-8757
Fax
(337) 477-8758
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD.201804 LA Primary

Addresses

Primary practice location

608 W McNeese St
Lake Charles, LA 70605-5530

Mailing address

608 W McNeese St
Lake Charles, LA 70605-5530
Phone (337) 477-8757

Other identifiers 1

IdentifierTypeStateIssuer
1216895MedicaidLA

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.201804LAMDRheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295049600000",
    "number": "1376540393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055530",
            "telephone_number": "337-477-8757",
            "fax_number": "337-477-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055530",
            "telephone_number": "337-477-8757",
            "fax_number": "337-477-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "JUSTIN",
        "middle_name": "STRYDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2011-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "MD.201804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1216895",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.