Active NPI
Lhyra Dawis Mayoralgo, PT
- Contractor
- Fort Wayne, IN
National Provider Identifier
1003940990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 05009021A
- Practice address
- 3512 Stellhorn Rd
Fort Wayne, IN 46815-4631 - Phone
- (260) 483-9081
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 05009021A | IN | Primary |
Addresses
Primary practice location
3512 Stellhorn Rd
Fort Wayne, IN 46815-4631
Mailing address
2734 Painted Desert Run
Fort Wayne, IN 46808-3560
Phone (317) 656-9654
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05009021A | IN | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329609600000",
"number": "1003940990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2734 PAINTED DESERT RUN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468083560",
"telephone_number": "317-656-9654",
"fax_number": "317-656-9654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 STELLHORN RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468154631",
"telephone_number": "260-483-9081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYORALGO",
"first_name": "LHYRA",
"middle_name": "DAWIS",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2012-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "IN",
"license": "05009021A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.