NPIMap

Individual provider Active NPI

Micki Dahne Lyons, NP-C

  • Family Nurse Practitioner
  • Sundance, WY
National Provider Identifier
1023445459
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19660.1267 Issued in WY
Practice address
713 W. Oak Street
Sundance, WY 82729
Phone
(307) 283-2476
Fax
(307) 283-2489
NPI assigned
Sep 30, 2013
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19660.1267 WY Primary

Addresses

Primary practice location

713 W. Oak Street
Sundance, WY 82729

Mailing address

6614 Bandon LN
Rapid City, SD 57702-9457
Phone (307) 680-5615

Other practice location 1

101 West Crook Street
Moorcroft, WY 82721
Phone (307) 756-3414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140414001487 WY Practitioner - Nurse Practitioner 1153553748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

713 E Oak St
Sundance, WY 82729-5172
Phone 3072833501173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19660.1267WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crook County Medical Services District CurrentSince Jan 11, 2014 Accepting new patients
Crook County Medical Services District CurrentSince Sep 25, 2013 Accepting new patients
Crook County Medical Services District CurrentSince Sep 25, 2013 Accepting new patients
Crook County Medical Services District Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Crook County Medical Services DistrictSundance, WY, CCN 531311 Hospital Operational/Managerial Control Apr 1, 2020
Crook County Medical Services DistrictSundance, WY, CCN 53Z311 Hospital Operational/Managerial Control Apr 1, 2020
Crook County Medical Services District Long Term CareSundance, WY, CCN 535029 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2020
May 1, 2020
Moorcroft ClinicMoorcroft, WY, CCN 533977 Rural health clinic Corporate Director
Operational/Managerial Control		 May 1, 2020
May 1, 2020
Hulett ClinicHulett, WY, CCN 533978 Rural health clinic Corporate Director
W-2 Managing Employee
Operational/Managerial Control		 May 1, 2020
May 1, 2020
May 1, 2020
Sundance ClinicSundance, WY, CCN 533976 Rural health clinic Corporate Director
W-2 Managing Employee		 May 1, 2020
Jun 1, 2016

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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

Hospital & facility affiliations 10

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1023445459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 BANDON LN",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029457",
            "telephone_number": "307-680-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W. OAK STREET",
            "city": "SUNDANCE",
            "state": "WY",
            "postal_code": "82729",
            "telephone_number": "307-283-2476",
            "fax_number": "307-283-2489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 West Crook Street",
            "address_purpose": "LOCATION",
            "city": "Moorcroft",
            "state": "WY",
            "postal_code": "82721",
            "country_code": "US",
            "telephone_number": "307-756-3414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "MICKI",
        "middle_name": "DAHNE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "19660.1267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sundance, WY

Sources for this page

Verify at the official NPI Registry.