Individual provider Active NPI

Charles Lunn Jr.

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1477529535
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16697 Issued in OK
Practice address
1720 NE 23Rd St
Oklahoma City, OK 73111-3324
Phone
(405) 280-5550
Fax
(405) 280-5780
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16697 OK Primary

Addresses

Primary practice location

1720 NE 23Rd St
Oklahoma City, OK 73111-3324

Mailing address

PO Box 659506
Section 4142
San Antonio, TX 78265-9506
Phone (405) 280-5550

Other identifiers 1

IdentifierTypeStateIssuer
100195290AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100503000169 OK Practitioner - Family Practice 8820167612 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16697OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
National Family Medical Associates, LLC Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Centennial Health, PC Family Medicine CurrentSince Jul 1, 1989 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

225 Lilac Dr
Ste 200
Edmond, OK 73034
Phone (405) 330-7000

701 NE 10th St
Oklahoma City, OK 73104
Phone (405) 232-8003

1720 NE 23rd St
Oklahoma City, OK 73111
Phone (405) 280-5550

7912 E 31st Ct
Ste 220
Tulsa, OK 74145
Phone (352) 572-5457

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1477529535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 659506",
            "address_2": "SECTION 4142",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782659506",
            "telephone_number": "405-280-5550",
            "fax_number": "405-280-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 NE 23RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731113324",
            "telephone_number": "405-280-5550",
            "fax_number": "405-280-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNN",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "16697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100195290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.