Individual provider Active NPI

Gregory Scott Lambeth, PH.D.

  • Clinical Psychologist
  • Urbana, IL
National Provider Identifier
1740407808
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005312 Issued in IL
Practice address
404 W Green St
Urbana, IL 61801-3267
Phone
(217) 384-3132
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071005312 IL Primary

Addresses

Primary practice location

404 W Green St
Urbana, IL 61801-3267

Mailing address

704 W Delaware Ave
Urbana, IL 61801-4807
Phone (217) 337-6227

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 Philosophy

State licenses

LicenseStateTypeSpecialty
071005312ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1740407808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 W DELAWARE AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618014807",
            "telephone_number": "217-337-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W GREEN ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618013267",
            "telephone_number": "217-384-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBETH",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.