Justin Lyons, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2158925 Issued in TX

Practice address

1201 Hewitt Dr Ste 107
Waco, TX 76712-8834

Phone

(254) 572-8890

NPI assigned

Jan 27, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Lildutchess LLC

  • Occupational Therapist
  • Temple, TX
  • NPI 1114580529
  NPD
• Mustard Seed Center, LLC

  • Developmental - Behavioral Pediatrics Physician
  • Waco, TX
  • NPI 1467326561
  NPD

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1003407602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HEWITT DR STE 107",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128834",
            "telephone_number": "254-572-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HEWITT DR STE 107",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128834",
            "telephone_number": "254-572-8890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 S 31st St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765023347",
            "country_code": "US",
            "telephone_number": "254-231-3752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "JUSTIN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2158925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kira Lynch, DDS
• Melissa K Lynn, WHNP-BC
• Sandra D. Lynn, CRNA
• Lynn'S la Vega Pharmacy, Inc
• Lynns la Vega Pharmacy Inc
• M-R Medical Inc
• M&T Pharmacy Solutions, LLC
• Mabell'S Place
• Lucinda Mabry, NP
• Bryce Elizabeth Macatol

• Physical Therapy Assistant in Waco, TX
• Providers in Waco, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.