Active NPI
Judin Lynch
- Exclusive Provider Organization
- Lawrenceville, GA
National Provider Identifier
1740604883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exclusive Provider Organization
- License
- 26-4017146
- Practice address
- 919 Koala CT
Lawrenceville, GA 30043-7699 - Phone
- (770) 635-8042
- Fax
- (877) 366-0737
- NPI assigned
- Feb 10, 2014
- Last updated
- Feb 10, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 26-4017146 | GA | Primary |
Addresses
Primary practice location
919 Koala CT
Lawrenceville, GA 30043-7699
Mailing address
919 Koala Court
Lawrenceville, GA 30043
Phone (770) 635-8042
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26-4017146 | GA | MD | Exclusive Provider Organization |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391990400000",
"number": "1740604883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 KOALA COURT",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "30043",
"telephone_number": "770-635-8042",
"fax_number": "877-366-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 KOALA CT",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300437699",
"telephone_number": "770-635-8042",
"fax_number": "877-366-0737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "JUDIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-10",
"last_updated": "2014-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "302F00000X",
"taxonomy_group": "",
"desc": "Exclusive Provider Organization",
"state": "GA",
"license": "26-4017146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.