Active NPI
Thomas Westbrook Lynch, M.D.
- Procedural Dermatology Physician
- Springfield, MO
National Provider Identifier
1669547436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- 32414
- Practice address
- 3850 S National Ave
Suite 730
Springfield, MO 65807-5287 - Phone
- (417) 269-7500
- Fax
- (417) 269-7502
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | 32414 | MO | Primary |
Addresses
Primary practice location
3850 S National Ave
Suite 730
Springfield, MO 65807-5287
Mailing address
3850 S National Ave
Suite 730
Springfield, MO 65807
Phone (417) 269-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18366 | Other | MO | BLUE CROSS BLUE SHEILD # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32414 | MO | MD | Procedural Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1669547436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3850 S NATIONAL AVE",
"address_2": "SUITE 730",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "65807",
"telephone_number": "417-269-7500",
"fax_number": "417-269-7502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3850 S NATIONAL AVE",
"address_2": "SUITE 730",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075287",
"telephone_number": "417-269-7500",
"fax_number": "417-269-7502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "THOMAS",
"middle_name": "WESTBROOK",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "MO",
"license": "32414",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD #",
"identifier": "18366",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.