Individual provider Active NPI

Theresa Noelle Lanham, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Owensboro, KY
National Provider Identifier
1972037208
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
05389 Issued in KY
Practice address
1000 Breckenridge St Ste 200
Owensboro, KY 42303-0876
Phone
(270) 691-8040
Fax
(270) 691-8049
NPI assigned
Apr 13, 2017
Last updated
Dec 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB10757100 NJ
Internal Medicine Physician 207R00000X OT017578 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X TP154 KY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 05389 KY Primary

Addresses

Primary practice location

1000 Breckenridge St Ste 200
Owensboro, KY 42303-0876

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

420 S 5th Ave
West Reading, PA 19611-2143
Phone (484) 628-8640

Other practice location 2

705 Haddonfield Berlin Rd
Voorhees, NJ 08043-3714
Phone (856) 679-0537

Other names 1

  • Theresa N. Lynn Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tlanham117666@direct.owensborohealth.org
Direct Messaging Address NJExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20230123000389 KY Practitioner - Endocrinology 4183993058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 Breckenridge St
Owensboro, KY 42303-0876

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

2211 Mayfair Dr
Owensboro, KY 42301-4569

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
TP154KYMDInternal Medicine Physician
25MB10757100NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc Endocrinology, Diabetes & Metabolism CurrentSince Dec 1, 2022 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Owensboro Health Medical Group, Inc Internal Medicine Past Accepting new patients

Locations

1000 Breckenridge St
Ste 200
Owensboro, KY 42303
Phone (270) 691-8040

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: tlanham117666@direct.owensborohealth.org

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1972037208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRECKENRIDGE ST STE 200",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423030876",
            "telephone_number": "270-691-8040",
            "fax_number": "270-691-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "196112143",
            "country_code": "US",
            "telephone_number": "484-628-8640",
            "fax_number": "484-628-9003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Haddonfield Berlin Rd",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080433714",
            "country_code": "US",
            "telephone_number": "856-679-0537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANHAM",
        "first_name": "THERESA",
        "middle_name": "NOELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10757100",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT017578",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "KY",
            "license": "TP154",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "KY",
            "license": "05389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlanham117666@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1000 Breckenridge St Ste 200",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423030876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "705 Haddonfield Berlin Rd",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080433714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "LYNN",
            "middle_name": "N.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.