Organization Active NPI

Willard Lynch Pmhnp-BC, PLLC

  • Psychiatry Physician
  • Tucson, AZ
National Provider Identifier
1467082404
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WILLARD LYNCH PMHNP-BC, PLLC
Practice address
4735 N 1St Ave
Tucson, AZ 85718-5610
Phone
(520) 552-6053
NPI assigned
Jan 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Willard LynchNPI 1801377601
Title
Sole Owner/Sole Practitioner
Phone
(520) 241-1426

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4735 N 1St Ave
Tucson, AZ 85718-5610

Mailing address

4735 N 1St Ave
Tucson, AZ 85718-5610
Phone (520) 552-6053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200226001930 AZ Part B Supplier - Clinic/Group Practice 7618304908 Receives reassigned benefits from 2 practitioners
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

1735 E Fort Lowell Rd
Ste 4
Tucson, AZ 85719
Phone (520) 327-6779

1735 E Fort Lowell Rd
Ste 6
Tucson, AZ 85719
Phone (210) 410-4995

4735 N 1st Ave
Tucson, AZ 85718
Phone (520) 829-5689

Practitioners & affiliated clinicians

Practitioners 3

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": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1467082404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 N 1ST AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857185610",
            "telephone_number": "520-552-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 N 1ST AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857185610",
            "telephone_number": "520-552-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLARD LYNCH PMHNP-BC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "WILLARD",
        "authorized_official_title_or_position": "SOLE OWNER/SOLE PRACTITIONER",
        "authorized_official_telephone_number": "520-241-1426"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.