Individual provider Active NPI

Robert Kevin Lynch

  • Surgery Physician
  • Odessa, TX
National Provider Identifier
1417953589
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
K3317 Issued in TX
Practice address
408 N Hancock Ave
Odessa, TX 79761-5140
Phone
(432) 580-7373
Fax
(432) 580-3275
NPI assigned
Jun 23, 2005
Last updated
Jan 24, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X K3317 TX Primary

Addresses

Primary practice location

408 N Hancock Ave
Odessa, TX 79761-5140

Mailing address

408 N Hancock Ave
Odessa, TX 79761-5140
Phone (432) 580-7373

Other identifiers 2

IdentifierTypeStateIssuer
079617901MedicaidTX
118257100OtherTXFIRSTCARE PROVIDER #

Other names 1

  • Robert Lynch Other name

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
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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 Osteopathy

Interoperability endpoints

  • Direct secure messaging: robert.lynch.1@1603.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1417953589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N HANCOCK AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615140",
            "telephone_number": "432-580-7373",
            "fax_number": "432-580-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N HANCOCK AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615140",
            "telephone_number": "432-580-7373",
            "fax_number": "432-580-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "ROBERT",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K3317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079617901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE PROVIDER #",
            "identifier": "118257100",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "LYNCH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.