Organization Active NPI

Jack Lund DO PA

  • General Practice Physician
  • Port Richey, FL
National Provider Identifier
1417148503
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS 0001626 Issued in FL
Legal business name
JACK LUND DO PA
Practice address
6545 Ridge Rd Ste 1
Port Richey, FL 34668-6865
Phone
(727) 843-8688
Fax
(727) 841-8300
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Authorized official

Name
Dr. Jack R Lund, DO
Title
Owner
Phone
(727) 843-8688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X OS 0001626 FL Primary

Addresses

Primary practice location

6545 Ridge Rd Ste 1
Port Richey, FL 34668-6865

Mailing address

6545 Ridge Rd Ste 1
Port Richey, FL 34668-6865
Phone (727) 843-8688

National Provider Directory

National Provider Directory

Locations

6545 Ridge Rd
Ste 1
Port Richey, FL 34668
Phone (727) 843-8688

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1417148503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 RIDGE RD STE 1",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346686865",
            "telephone_number": "727-843-8688",
            "fax_number": "727-841-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 RIDGE RD STE 1",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346686865",
            "telephone_number": "727-843-8688",
            "fax_number": "727-841-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK LUND DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "LUND",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-843-8688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS 0001626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.