NPIMap

Individual provider Active NPI

Rayan M Lungba, M.B.B.S

  • Family Medicine Physician
  • Friendship, WI
National Provider Identifier
1972180438
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
85518 Issued in WI
Practice address
402 W Lake St
Friendship, WI 53934-9699
Phone
(608) 339-3331
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-16468 AR
Family Medicine Physician 207Q00000X 85518 WI Primary

Addresses

Primary practice location

402 W Lake St
Friendship, WI 53934-9699

Mailing address

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

Other practice location 1

1601 W 40th Ave Ste 100
Pine Bluff, AR 71603-6069
Phone (870) 541-6010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230906003713 AR Practitioner - Family Practice 2769846989 Reassigns benefits to 5 organizations
I20250723000915 WI Practitioner - Family Practice 2769846989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-16468ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Jul 28, 2025 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc Family Medicine CurrentSince Jul 28, 2025 Accepting new patients
Ess of Fordyce LLC CurrentSince Aug 15, 2023 Accepting new patients
Ess of McGehee LLC CurrentSince Aug 15, 2023 Accepting new patients
Ess Hospitalist LLC CurrentSince Aug 15, 2023 Accepting new patients
Hospital Care Consultants of Fordyce LLC CurrentSince Aug 15, 2023 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc CurrentSince Aug 15, 2023 Accepting new patients

Locations

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

201 N Clifton St
Fordyce, AR 71742
Phone (870) 352-6300

2729 S Highway 65 82
Lake Village, AR 71653
Phone (870) 265-5351

900 S 3rd St
McGehee, AR 71654
Phone (855) 498-6768

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: rlungba1077583@direct.gundersenhealth.org

Organizations & group practices 7

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 2

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1972180438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 W 40th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716036069",
            "country_code": "US",
            "telephone_number": "870-541-6010",
            "fax_number": "870-541-6009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNGBA",
        "first_name": "RAYAN",
        "middle_name": "M",
        "credential": "M.B.B.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-16468",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "85518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendship, WI

Sources for this page

Verify at the official NPI Registry.