Active NPI
Michael M Lundy, MD
- Diagnostic Radiology Physician
- Jackson, TN
National Provider Identifier
1447205752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 24632
- Practice address
- 700 W Forest Ave
Ste 300
Jackson, TN 38301-3937 - Phone
- (731) 422-0288
- Fax
- (731) 422-0317
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 24632 | TN | Primary |
Addresses
Primary practice location
700 W Forest Ave
Ste 300
Jackson, TN 38301-3937
Mailing address
PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24632 | TN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helena Imaging, PLLC | Diagnostic Radiology | Past | Accepting new patients |
| Imaging Associates of North Mississippi Magnolia PLLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Diagnostic Radiology Physician
- Helena, AR
- NPI 1710203609
-
- Diagnostic Radiology Physician
- Corinth, MS
- NPI 1578512919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385510400000",
"number": "1447205752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 400",
"city": "JACKSON",
"state": "TN",
"postal_code": "383020400",
"telephone_number": "731-423-8697",
"fax_number": "731-422-5743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W FOREST AVE",
"address_2": "STE 300",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013937",
"telephone_number": "731-422-0288",
"fax_number": "731-422-0317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDY",
"first_name": "MICHAEL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2013-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "24632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.