Individual provider Active NPI

Ashley Marie Lyons

  • Physician Assistant
  • Carrollton, VA
National Provider Identifier
1104387539
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006757 Issued in VA
Practice address
15221 Carrollton Blvd Ste 102
Carrollton, VA 23314-2325
Phone
(757) 231-6966
Fax
(757) 432-3183
NPI assigned
Mar 28, 2019
Last updated
Oct 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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

15221 Carrollton Blvd Ste 102
Carrollton, VA 23314-2325

Mailing address

15221 Carrollton Blvd Ste 102
Carrollton, VA 23314-2325
Phone (757) 231-6966

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
0110006757VAMDPsychiatry Physician

Practice roles

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

Locations

15221 Carrollton Blvd
Ste 102
Carrollton, VA 23314
Phone (757) 922-3085

8401 Mayland Dr
Ste 8226
Henrico, VA 23294

8401 Mayland Dr
Ste A
Richmond, VA 23294
Phone (804) 256-3116

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, 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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792454400000",
    "number": "1104387539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15221 CARROLLTON BLVD STE 102",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233142325",
            "telephone_number": "757-231-6966",
            "fax_number": "757-432-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15221 CARROLLTON BLVD STE 102",
            "city": "CARROLLTON",
            "state": "VA",
            "postal_code": "233142325",
            "telephone_number": "757-231-6966",
            "fax_number": "757-432-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "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 Carrollton, VA

Sources for this page

Verify at the official NPI Registry.