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1376860924 NPI number — JENNA WALTERS LAMBETH M.D.

NPI Number: 1376860924
Health Care Provider/Practitioner: JENNA WALTERS LAMBETH M.D.

Information about “1376860924” NPI (JENNA WALTERS LAMBETH M.D.) exists in 1376860924 in HTML format HTML  |  1376860924 in plain Text format TXT  |  1376860924 in PDF (Portable Document Format) PDF  |  1376860924 in an XML format XML  formats.

NPI Number : 1376860924 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376860924",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LAMBETH",
    "FirstName": "JENNA",
    "MiddleName": "WALTERS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WALTERS",
    "OtherFirstName": "JENNA",
    "OtherMiddleName": "LEIGH",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1212 SPRUCE ST STE 209",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BELMONT",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28012-3386",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "704-862-4700",
    "MailingAddressFaxNumber": "704-862-4749",
    "FirstLinePracticeLocationAddress": "1212 SPRUCE ST STE 209",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BELMONT",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28012-3386",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "704-862-4700",
    "PracticeLocationAddressFaxNumber": "704-862-4749",
    "EnumerationDate": "04/22/2010",
    "LastUpdateDate": "06/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207LP2900X",
          "TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
          "LicenseNumber": "MD48098",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207LP2900X",
          "TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
          "LicenseNumber": "38755",
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208VP0000X",
          "TaxonomyName": "Pain Medicine Physician",
          "LicenseNumber": "201500648",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207LP2900X",
          "TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
          "LicenseNumber": "201500648",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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