Individual provider Active NPI

Charles J Lyons, DC

  • Chiropractor
  • Sterling Heights, MI
National Provider Identifier
1114941119
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CL007629 Issued in MI
Practice address
36150 Dequindre Rd
Suite 730
Sterling Heights, MI 48310-7149
Phone
(586) 979-4950
Fax
(586) 979-5096
NPI assigned
Jul 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CL007629 MI Primary

Addresses

Primary practice location

36150 Dequindre Rd
Suite 730
Sterling Heights, MI 48310-7149

Mailing address

505 River Ridge Dr
Waterford, MI 48327-2887
Phone (248) 941-5330

Other identifiers 1

IdentifierTypeStateIssuer
3384548MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040731000356 MI Practitioner - Chiropractic 0547230930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael J Brown,D.C.,P.C.Group PAC ID 9739150574, 2 clinicians

Practice addresses (Care Compare)

36150 Dequindre Rd
Sterling Heights, MI 48310-7142
Phone (586) 979-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CL007629MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J Brown,D.C.,P.C. Chiropractor CurrentSince Jan 26, 2004 Accepting new patients

Locations

2121 15 Mile Rd
Sterling Heights, MI 48310
Phone (586) 264-2225

36150 Dequindre Rd
Ste 730
Sterling Hts, MI 48310
Phone (586) 979-4950

Organizations & group practices 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114941119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 RIVER RIDGE DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483272887",
            "telephone_number": "248-941-5330",
            "fax_number": "586-979-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36150 DEQUINDRE RD",
            "address_2": "SUITE 730",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483107149",
            "telephone_number": "586-979-4950",
            "fax_number": "586-979-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "CL007629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3384548",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

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.
  • 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.