Jack Leroy Loynes, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301005922 Issued in MI

Practice address

4572 S Hagadorn Rd
Suite 2a East
East Lansing, MI 48823-5385

Phone

(517) 349-8388

Fax

(517) 349-1560

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1578664694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD",
            "address_2": "SUITE 2A EAST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-349-8388",
            "fax_number": "517-349-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD",
            "address_2": "SUITE 2A EAST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-349-8388",
            "fax_number": "517-349-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOYNES",
        "first_name": "JACK",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301005922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2",
            "identifier": "680C346250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.