Individual provider Active NPI

Ashley Marie Lyons

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1104387539
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006757 Issued in VA
Practice address
2501 James Madison Dr
Virginia Beach, VA 23456-9107
Phone
(757) 803-8132
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0110006757 VA
Physician Assistant 363A00000X 0110006757 VA Primary

Addresses

Primary practice location

2501 James Madison Dr
Virginia Beach, VA 23456-9107

Mailing address

1064 Laskin Rd Ste 14C
Virginia Beach, VA 23451-6337

Other practice location 1

1064 Laskin Rd Ste 14C
Virginia Beach, VA 23451-6337
Phone (757) 233-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190828000595 VA Practitioner - Physician Assistant 7911235007 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110006757VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Village Psychiatry LLC Physician Assistant Current Accepting new patients
Tidewater Psychotherapy Services PastSince Jul 24, 2022 Accepting new patients

Locations

8401 Mayland Dr
Ste 8226
Henrico, VA 23294

8401 Mayland Dr
Ste A
Richmond, VA 23294
Phone (703) 859-2848

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1104387539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 LASKIN RD STE 14C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 JAMES MADISON DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234569107",
            "telephone_number": "757-803-8132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1064 Laskin Rd Ste 14C",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234516337",
            "country_code": "US",
            "telephone_number": "757-233-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-10-06",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0110006757",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.