Individual provider Active NPI

James Arnold Luebbers, MD

  • Ophthalmology Physician
  • Jackson, WY
National Provider Identifier
1477879062
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
6046A Issued in WY
Practice address
687 East Kelly Ave.
BX 3797
Jackson, WY 83001-3797
Phone
(307) 734-6553
Fax
(307) 733-8444
NPI assigned
Apr 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G34211 CA
Ophthalmology Physician 207W00000X 6046A WY Primary

Addresses

Primary practice location

687 East Kelly Ave.
BX 3797
Jackson, WY 83001-3797

Mailing address

687 East Kelly Ave.
BX 3797
Jackson, WY 83001-3797
Phone (307) 734-6553

Other identifiers 1

IdentifierTypeStateIssuer
00G342110MedicaidCA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G34211CAMDOphthalmology Physician
6046AWYMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1477879062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 EAST KELLY AVE.",
            "address_2": "BX 3797",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830013797",
            "telephone_number": "307-734-6553",
            "fax_number": "307-733-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 EAST KELLY AVE.",
            "address_2": "BX 3797",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830013797",
            "telephone_number": "307-734-6553",
            "fax_number": "307-733-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEBBERS",
        "first_name": "JAMES",
        "middle_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G34211",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WY",
            "license": "6046A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G342110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.