Lacuna Family Medicine, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

1038449 Issued in AK

Legal business name

LACUNA FAMILY MEDICINE, INC.

Practice address

204 4TH Ave
Seward, AK 99664

Phone

(907) 491-0645

NPI assigned

Aug 28, 2016

Last updated

Aug 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerald P. Flynn Jr., MD

Title

President

Phone

(907) 491-0645

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry Paul Flynn Jr., M.D.

  • Family Medicine Physician
  • Seward, AK
  • NPI 1003070780
  Medicare reassignment NPD

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1902352206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2816",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "996642816",
            "telephone_number": "907-491-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 4TH AVE",
            "city": "SEWARD",
            "state": "AK",
            "postal_code": "99664",
            "telephone_number": "907-491-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACUNA FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-491-0645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AK",
            "license": "1038449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD9543",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Kim
• Beth Kinegak
• Alexis M Klapproth, RN, MSN, CWS
• Kristopher Knox
• Mary Beth Koster, OTR/L
• Lori Landstrom, PA C
• Cynthia Langmade, PA-C, NP
• Kelsey Lee
• Charlene Lenhart
• Carly Locke

• Primary Care Clinic/Center in Seward, AK
• Providers in Seward, AK by specialty
• Primary Care Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.