Individual provider Active NPI

Michael J Lemberger, MD

  • Addiction Medicine (Family Medicine) Physician
  • Spokane, WA
National Provider Identifier
1720070139
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
MD00018979 Issued in WA
Practice address
611 E 2ND Ave
Suite B
Spokane, WA 99202-6010
Phone
(509) 822-7395
Fax
(509) 822-7392
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X MD00018979 WA Primary

Addresses

Primary practice location

611 E 2ND Ave
Suite B
Spokane, WA 99202-6010

Mailing address

611 E 2ND Ave
Suite B
Spokane, WA 99202-6010
Phone (509) 822-7395

Other identifiers 1

IdentifierTypeStateIssuer
8174245MedicaidWA

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

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1720070139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E 2ND AVE",
            "address_2": "SUITE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992026010",
            "telephone_number": "509-822-7395",
            "fax_number": "509-822-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E 2ND AVE",
            "address_2": "SUITE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992026010",
            "telephone_number": "509-822-7395",
            "fax_number": "509-822-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMBERGER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD00018979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8174245",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.