Active NPI
Raven Danielle Lyles
- Certified Registered Nurse Anesthetist
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0024186691
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, MD
Enrollment records 3
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6828 | NC | MD | Speech-Language Pathologist |
| 904663 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group Anesthesiology LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | Accepting new patients | |
| Inova Cares - Community | Current | Accepting new patients | |
| Medstar Medical Group Anesthesiology LLC | Current | Accepting new patients | |
| Medstar Medical Group II LLC | Current | 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.
-
- Anesthesiology Physician
- Virginia Beach, VA
- NPI 1518205004
-
- Anesthesiology Physician
- Washington, DC
- NPI 1558976175
-
- Internal Medicine Physician
- Washington, DC
- NPI 1376887844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Harrisonburg, VA
- NPI 1780694372
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.