Individual provider Active NPI

Raven Danielle Lyles

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
National Provider Identifier
1013661230
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024186691 Issued in VA
Practice address
200 Hawthorne LN
Charlotte, NC 28204-2515
Phone
(704) 384-4274
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024186691 VA Primary
Registered Nurse 163W00000X 904663 MS
Certified Registered Nurse Anesthetist 367500000X 6828 NC

Addresses

Primary practice location

200 Hawthorne LN
Charlotte, NC 28204-2515

Mailing address

355 Old Spanish TRL
Jackson, MS 39212-3210
Phone (601) 405-1782

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231206001227 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880080597 Reassigns benefits to 2 organizations
I20231207000286 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880080597 Reassigns benefits to 3 organizations
I20240423000985 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880080597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

810 Bestgate Rd
Annapolis, MD 21401-3648
Phone (410) 573-1110

830 Kempsville Rd
Norfolk, VA 23502-3920
Phone (757) 261-6000

Hospital & facility affiliations

  • Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6828NCMDSpeech-Language Pathologist
904663MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Anesthesiology LLC CurrentSince Apr 11, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Inova Cares - Community CurrentSince Nov 1, 2023 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Apr 11, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

810 Bestgate Rd
Annapolis, MD 21401
Phone (410) 573-1110

810 Bestgate Rd
Ste 300
Annapolis, MD 21401
Phone (410) 782-7611

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1013661230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 OLD SPANISH TRL",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392123210",
            "telephone_number": "601-405-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042515",
            "telephone_number": "704-384-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES",
        "first_name": "RAVEN",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024186691",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "904663",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6828",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.