Individual provider Active NPI

John Anthony Lyons, CRNA

  • Certified Registered Nurse Anesthetist
  • Leitchfield, KY
National Provider Identifier
1033408729
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1105326 Issued in KY
Practice address
904 Wallace Ave
Leitchfield, KY 42754-1418
Phone
(270) 259-9470
NPI assigned
Apr 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1105326 KY Primary

Addresses

Primary practice location

904 Wallace Ave
Leitchfield, KY 42754-1418

Mailing address

1020 N Main St
Beaver Dam, KY 42320-1553
Phone (270) 556-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130919000237 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668616350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Conoloway Anesthesia PLLCGroup PAC ID 9133590201, 6 clinicians

Practice addresses (Care Compare)

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9400

Hospital & facility affiliations

  • Owensboro Health Twin Lakes Medical Center Hospital, Leitchfield, KY, CCN 180070
  • Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1105326KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Conoloway Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 13, 2022 Accepting new patients

Locations

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

Organizations & group practices 1

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 2

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": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1033408729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423201553",
            "telephone_number": "270-556-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541418",
            "telephone_number": "270-259-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "1105326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leitchfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.