Active NPI
Kiyun Maurice Lynch, LAT, ATC
- Athletic Trainer
- Albuquerque, NM
National Provider Identifier
1972056323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 635
- Practice address
- 10800 Dennis Chavez Blvd SW
Albuquerque, NM 87121-5498 - Phone
- (505) 243-1458
- NPI assigned
- Aug 2, 2016
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 635 | NM | Primary |
Addresses
Primary practice location
10800 Dennis Chavez Blvd SW
Albuquerque, NM 87121-5498
Mailing address
10800 Dennis Chavez Blvd SW
Albuquerque, NM 87121-5498
Phone (505) 243-1458
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1972056323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10800 DENNIS CHAVEZ BLVD SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871215498",
"telephone_number": "505-243-1458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10800 DENNIS CHAVEZ BLVD SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871215498",
"telephone_number": "505-243-1458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "KIYUN",
"middle_name": "MAURICE",
"name_prefix": "Mr.",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-02",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NM",
"license": "635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.