Individual provider Active NPI

Jonathan P Lynch, MD

  • Family Medicine Physician
  • Cairo, GA
National Provider Identifier
1477578599
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
060402 Issued in GA
Practice address
1178 5TH St SE
Cairo, GA 39828-3141
Phone
(229) 377-2002
Fax
(229) 377-0930
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TL27868 SC
Family Medicine Physician 207Q00000X 060402 GA Primary

Addresses

Primary practice location

1178 5TH St SE
Cairo, GA 39828-3141

Mailing address

1178 5TH St SE
Cairo, GA 39828-3141
Phone (229) 377-2002

Other identifiers 2

IdentifierTypeStateIssuer
124633161AMedicaidGA
278684MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080716000058 GA Practitioner - Family PracticePractitioner - Obstetrics/GynecologyPractitioner - Pediatric Medicine 3476626029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology, Pediatric Medicine
Education
Mercer University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Life Center LLCGroup PAC ID 1557606779, 4 clinicians

Practice addresses (Care Compare)

1842 US Hwy 84 W
Cairo, GA 39827-4224
Phone (229) 397-5453

Hospital & facility affiliations

  • Archbold Home Health Services Home health agency, Thomasville, GA, CCN 117024
  • Georgia Hospice Care Hospice, Albany, GA, CCN 111773
  • Grady General Hospital Hospital, Cairo, GA, CCN 110121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL27868SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County 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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1477578599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 5TH ST SE",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398283141",
            "telephone_number": "229-377-2002",
            "fax_number": "229-377-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 5TH ST SE",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398283141",
            "telephone_number": "229-377-2002",
            "fax_number": "229-377-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "TL27868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "060402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124633161A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278684",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cairo, GA

Sources for this page

Verify at the official NPI Registry.