Active NPI
Shannon Lee Lyle, ATC
- Athletic Trainer
- Knoxville, TN
National Provider Identifier
1053645424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 586
- Practice address
- 1120 E Weisgarber Rd Ste 101
Knoxville, TN 37909-3606 - Phone
- (865) 584-1054
- NPI assigned
- Oct 1, 2009
- Last updated
- Oct 1, 2009
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 586 | TN | Primary |
Addresses
Primary practice location
1120 E Weisgarber Rd Ste 101
Knoxville, TN 37909-3606
Mailing address
915 Whitesburg Dr
Knoxville, TN 37918-8960
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 |
|---|---|---|---|
| 586 | TN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familycare Specialists PC | Past | Accepting new patients | |
| Covenant Medical Group, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1881636488
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1033447008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1053645424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 WHITESBURG DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379188960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 E WEISGARBER RD STE 101",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379093606",
"telephone_number": "865-584-1054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYLE",
"first_name": "SHANNON",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.