Individual provider Active NPI

Matthew John Lynam, DC

  • Chiropractor
  • North Syracuse, NY
National Provider Identifier
1386710135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0041061 Issued in NY
Practice address
345 Chestnut Street
North Syracuse, NY 13212
Phone
(315) 458-2500
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0041061 NY Primary

Addresses

Primary practice location

345 Chestnut Street
North Syracuse, NY 13212

Mailing address

345 Chestnut Street
North Syracuse, NY 13212
Phone (315) 458-2500

Other identifiers 1

IdentifierTypeStateIssuer
C04106OtherNYWORKERS COMPENSATION

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0041061NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386710135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CHESTNUT STREET",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-458-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CHESTNUT STREET",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-458-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNAM",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0041061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "C04106",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.