NPIMap

Individual provider Active NPI

James Edgar Lundeen Sr., M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Plymouth, OH
National Provider Identifier
1962654731
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
35052257 Issued in OH
Practice address
26 Sandusky St
Plymouth, OH 44865-1113
Phone
(419) 687-4322
Fax
(419) 687-4323
NPI assigned
Oct 10, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 35052257 OH Primary
General Practice Physician 208D00000X 35052257 OH
Legal Medicine (M.D./D.O.) Physician 209800000X 35052257 OH
Pain Medicine Physician 208VP0000X 35052257 OH
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 35052257 OH

Addresses

Primary practice location

26 Sandusky St
Plymouth, OH 44865-1113

Mailing address

26 Sandusky St
Plymouth, OH 44865-1113
Phone (419) 687-4322

Other identifiers 2

IdentifierTypeStateIssuer
0604322MedicaidOH
0808943OtherOHMEDICARE PTAN

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35052257OHMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Ohio Chiro Past Accepting new patients
Oral & Maxillofacial Surgeons Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1962654731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SANDUSKY ST",
            "city": "PLYMOUTH",
            "state": "OH",
            "postal_code": "448651113",
            "telephone_number": "419-687-4322",
            "fax_number": "419-687-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SANDUSKY ST",
            "city": "PLYMOUTH",
            "state": "OH",
            "postal_code": "448651113",
            "telephone_number": "419-687-4322",
            "fax_number": "419-687-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDEEN",
        "first_name": "JAMES",
        "middle_name": "EDGAR",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-10",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "OH",
            "license": "35052257",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35052257",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "OH",
            "license": "35052257",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OH",
            "license": "35052257",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "OH",
            "license": "35052257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0604322",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0808943",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; 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.