Jack C Lunderman Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35-052430 Issued in OH

Practice address

7901 Schatz Pointe Dr
Suite a
Dayton, OH 45459-3856

Phone

(937) 438-9841

Fax

(937) 438-9851

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Wright State University Boonshoft School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jlunderman181421@direct.ketteringhealth.org

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.

• S Jean Budding Inc

  • Adult Psychiatric/Mental Health Registered Nurse
  • Dayton, OH
  • NPI 1780823237
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1871694679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 SCHATZ POINTE DR",
            "address_2": "SUITE A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593856",
            "telephone_number": "937-438-9841",
            "fax_number": "937-438-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 SCHATZ POINTE DR",
            "address_2": "SUITE A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593856",
            "telephone_number": "937-438-9841",
            "fax_number": "937-438-9851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3996",
            "fax_number": "937-723-3498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDERMAN",
        "first_name": "JACK",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-052430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0720689",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlunderman181421@direct.ketteringhealth.oeg",
            "affiliation": "N",
            "address_1": "405 W Grand Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454057538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "405 W Grand Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454057538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittani Luker
• Rebecca Luker
• Craig Lumpkin Sr.
• Tonya Lumpkins
• Kathleen R Lundeberg, DO
• Sarah Ann Lunsford, NP
• Heather Luong
• Alonza Luster
• Justin Darnell Luster
• Laura Luthy, PA-C

• Psychiatry Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.