Individual provider Active NPI

Judith Richardson Lubbers, M.D.

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1639128440
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35054890L Issued in OH
Practice address
1166 Dublin Rd Ste 400
Columbus, OH 43215-1081
Phone
(740) 380-8344
NPI assigned
May 9, 2006
Last updated
Dec 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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 35054890L OH Primary

Addresses

Primary practice location

1166 Dublin Rd Ste 400
Columbus, OH 43215-1081

Mailing address

22498 Clay Lick Rd
Logan, OH 43138-9749
Phone (740) 380-9241

Other identifiers 4

IdentifierTypeStateIssuer
0945062MedicaidOH
000000367000OtherOHBCBS
000000315927OtherHOCKING BCBS
P00252404OtherMEDICARE RR HOCKING

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35054890LOHMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1639128440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22498 CLAY LICK RD",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389749",
            "telephone_number": "740-380-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 DUBLIN RD STE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151081",
            "telephone_number": "740-380-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBBERS",
        "first_name": "JUDITH",
        "middle_name": "RICHARDSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35054890L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0945062",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000367000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOCKING BCBS",
            "identifier": "000000315927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR HOCKING",
            "identifier": "P00252404",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.