Provider Demographics
NPI:1073622148
Name:CASEY, JAMES LYNN (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LYNN
Last Name:CASEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1301
Mailing Address - Country:US
Mailing Address - Phone:785-354-6241
Mailing Address - Fax:785-270-4343
Practice Address - Street 1:1500 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1301
Practice Address - Country:US
Practice Address - Phone:785-354-6241
Practice Address - Fax:785-270-4343
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17200208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
370017514OtherRR MEDICARE
KS100085610BMedicaid
MO205142201Medicaid
MO27320011OtherBCBS KANSAS CITY
KS100085610CMedicaid
KS068002097OtherMEDICARE PTAN
KS610461OtherFIRSTGUARD
370017514OtherRR MEDICARE
B69252Medicare UPIN