Individual provider Active NPI

Justin David Wright, MD

  • Family Medicine Physician
  • Lebanon, IN
National Provider Identifier
1386613909
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01059454A Issued in IN
Practice address
2705 N Lebanon St Ste 300
Lebanon, IN 46052-8622
Phone
(765) 485-8649
Fax
(765) 485-8650
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01059454A IN Primary

Addresses

Primary practice location

2705 N Lebanon St Ste 300
Lebanon, IN 46052-8622

Mailing address

2605 N Lebanon St
Lebanon, IN 46052-1476

Other identifiers 1

IdentifierTypeStateIssuer
200488340MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwright@withamdirect.org Health Information Exchange (HIE) Witham Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060628000254 IN Practitioner - Family Practice 2668484080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

1650 W Oak St
Zionsville, IN 46077-3835

2485 E Wabash
Frankfort, IN 46041-9400
Phone (765) 659-7400

2485 E Wabash St
Suite 110
Frankfort, IN 46041-9400
Phone (765) 659-7400

2705 N Lebanon St
Lebanon, IN 46052-8622

400 N Mount Zion Rd
Lebanon, IN 46052-9497
Phone (765) 335-0123

Hospital & facility affiliations

  • Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
  • Witham Health Services Hospital, Lebanon, IN, CCN 150104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01059454AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital CurrentSince Jun 1, 2006 Accepting new patients
Witham Memorial Hospital Family Medicine CurrentSince Jun 1, 2006 Accepting new patients
Major Hospital Past Accepting new patients

Locations

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2705 N Lebanon St
Ste 300
Lebanon, IN 46052
Phone (765) 482-8649

400 N Mount Zion Rd
Lebanon, IN 46052
Phone (765) 335-0123

2705 N Lebanon St
Ste 305
Lebanon, IN 46052
Phone (765) 485-8677

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

1650 W Oak St
Ste 100
Zionsville, IN 46077
Phone (317) 873-8800

Interoperability endpoints

  • Direct secure messaging: jwright@withamdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1386613909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 300",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528622",
            "telephone_number": "765-485-8649",
            "fax_number": "765-485-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01059454A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200488340",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwright@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2705 N Lebanon St Ste 300",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460528622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lebanon, IN

Sources for this page

Verify at the official NPI Registry.