Individual provider Active NPI

Michael C Lyons, DC

  • Rehabilitation Chiropractor
  • Boardman, OH
National Provider Identifier
1043376783
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2826 Issued in OH
Practice address
755 Boardman Canfield Rd Ste P1
Boardman, OH 44512-7325
Phone
(330) 726-7404
Fax
(330) 729-9166
NPI assigned
Dec 28, 2006
Last updated
Jan 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 2826 OH Primary

Addresses

Primary practice location

755 Boardman Canfield Rd Ste P1
Boardman, OH 44512-7325

Mailing address

P.O. Box 3351
Boardman, OH 44513
Phone (330) 726-7404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090827000136 OH Practitioner - Chiropractic 1456406479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Chiropractic and Rehab, Inc.Group PAC ID 7618022633, 3 clinicians

Practice addresses (Care Compare)

730 N Main St
Hubbard, OH 44425-1126
Phone (330) 707-0979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic & Rehab, Inc. Rehabilitation CurrentSince Apr 24, 2009 Accepting new patients
Advanced Chiropractic & Rehab, Inc. Past Accepting new patients
Advanced Chiropractic and Rahabilitation, LLC Past Accepting new patients

Locations

1315 Boardman Canfield Rd
Ste 3
Boardman, OH 44512

730 N Main St
Hubbard, OH 44425
Phone (330) 259-0788

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1043376783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3351",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "44513",
            "telephone_number": "330-726-7404",
            "fax_number": "330-729-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 BOARDMAN CANFIELD RD STE P1",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445127325",
            "telephone_number": "330-726-7404",
            "fax_number": "330-729-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OH",
            "license": "2826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.