Michael Lynn, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

122180 Issued in CO

Practice address

2500 West a Ste.
Ste #1
Moscow, ID 83843

Phone

(208) 882-0540

Fax

(208) 882-1487

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington State University

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1285713776
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1811027204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 SOUTH MAIN ST.",
            "address_2": "STE #1",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432983",
            "telephone_number": "208-882-2011",
            "fax_number": "208-883-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 WEST A STE.",
            "address_2": "STE #1",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-882-0540",
            "fax_number": "208-882-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "122180",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ID",
            "license": "NP-941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE #",
            "identifier": "122180",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO NURSING LICENSE",
            "identifier": "NP-941",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Mae Luna
• Teleea Tawnee Lundgren, LMT, NCTMB
• James Rion Lutz
• Douglas Patrick Lynch, DPT
• Michele Lynch, LCPC
• Nathan Lyon
• Cass Mabbutt, LAC, EAMP
• Lori Marie Mages, PT, PCS
• Candace Louise Magnuson, LMT
• Diego Maldonado Quezada

• Nurse Practitioner in Moscow, ID
• Providers in Moscow, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.