Individual provider Active NPI

William Stuart Lynne, L.P.P.

  • Psychologist
  • Fort Thomas, KY
National Provider Identifier
1417901083
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
KY-0023 Issued in KY
Practice address
18 N Fort Thomas Ave
Fort Thomas, KY 41075-3098
Phone
(859) 816-4279
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X KY-0023 KY Primary

Addresses

Primary practice location

18 N Fort Thomas Ave
Fort Thomas, KY 41075-3098

Mailing address

1643 N Fort Thomas Ave
Fort Thomas, KY 41075-1118
Phone (859) 816-4279

Other identifiers 1

IdentifierTypeStateIssuer
184607OtherKYMEDICARE GROUP NUMBER

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

State licenses

LicenseStateTypeSpecialty
KY-0023KYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1417901083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 N FORT THOMAS AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410751118",
            "telephone_number": "859-816-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N FORT THOMAS AVE",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410753098",
            "telephone_number": "859-816-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNNE",
        "first_name": "WILLIAM",
        "middle_name": "STUART",
        "credential": "L.P.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "KY-0023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "184607",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.