Destry W Lambert, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01024399 Issued in IN

Practice address

403 Fairgrounds Rd
Tipton, IN 46072-9596

Phone

(765) 675-7601

Fax

(765) 675-8052

NPI assigned

Oct 18, 2005

Last updated

Sep 24, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Central Indiana Physician Alliance, LLC

  dba IU Health Tipton Physicians

  • Family Medicine Physician
  • Tipton, IN
  • NPI 1114105517
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1427047950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460720358",
            "telephone_number": "765-675-8119",
            "fax_number": "765-675-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 FAIRGROUNDS RD",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460729596",
            "telephone_number": "765-675-7601",
            "fax_number": "765-675-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT",
        "first_name": "DESTRY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01024399",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01024399A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100233710A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnson Memorial Hospital (The Waters of Tipton Skilled Nursing Facility)
• Kelly Jean Jones, APRN, FNP-C
• Jennifer L Julian, LCSW
• Richard Sukhee Jung, DO
• Charles Lai, MD
• Walter Samuel Langkau, D.D.S.
• Kristi S Leap, MSW, LCSW
• Janette R Link
• Lori M Wisely M D
• Mary Katherine Mariotti, FNP-BC

• General Practice Physician in Tipton, IN
• Providers in Tipton, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.