Active NPI
Corey A Lyons, LPN
- Licensed Practical Nurse
- Winslow, AZ
National Provider Identifier
1053471938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LPO37389
- Practice address
- 600 E Cherry St
Winslow, AZ 86047-3806 - Phone
- (928) 288-8100
- NPI assigned
- Dec 11, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPO37389 | AZ | Primary |
Addresses
Primary practice location
600 E Cherry St
Winslow, AZ 86047-3806
Mailing address
209 E Hillview St
Winslow, AZ 86047-2711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 962705 | Other | AZ | AHCCCS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPO37389 | AZ | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053471938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 E HILLVIEW ST",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860472711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E CHERRY ST",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860473806",
"telephone_number": "928-288-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "COREY",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "AZ",
"license": "LPO37389",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "962705",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winslow, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.