Lydia Anna Zellers, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

Lyster Army Health Clinic
301 Andrews Ave
Fort Rucker, AL 36362-5333

Phone

(800) 261-7193

Fax

(334) 255-7710

NPI assigned

Feb 1, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lydia Anna Van Winkle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1033415583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "570-295-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LYSTER ARMY HEALTH CLINIC",
            "address_2": "301 ANDREWS AVE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "363625333",
            "telephone_number": "800-261-7193",
            "fax_number": "334-255-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLERS",
        "first_name": "LYDIA",
        "middle_name": "ANNA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-01",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "VAN WINKLE",
            "middle_name": "ANNA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julee Wood, RN
• Massi Hugh Wyatt, PSY.D
• X Awaiting Inactivation3
• Alexa E Yohn, RN
• Angela Marie York, OPTOMETRY HEALTH TEC
• Ricky Dean Zhorne Jr., EMT
• Diane Michelle Zierhoffer, PHD

• Physician Assistant in Fort Rucker, AL
• Providers in Fort Rucker, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.