Active NPI
Jerry Douglas Lynch, PA
- Physician Assistant
- Corpus Christi, TX
National Provider Identifier
1962630749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00276
- Practice address
- 3845 S Padre Island Dr
Corpus Christi, TX 78415-2919 - Phone
- (361) 854-4626
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00276 | TX | Primary |
Addresses
Primary practice location
3845 S Padre Island Dr
Corpus Christi, TX 78415-2919
Mailing address
6340 S Padre Island Dr
Corpus Christi, TX 78412-4038
Phone (361) 854-4626
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00276 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1962630749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6340 S PADRE ISLAND DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784124038",
"telephone_number": "361-854-4626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3845 S PADRE ISLAND DR",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784152919",
"telephone_number": "361-854-4626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "JERRY",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA00276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.