Individual provider Active NPI

Kianna Michelle Lyons, NP

  • Acute Care Nurse Practitioner
  • Saint Clair Shores, MI
National Provider Identifier
1134435878
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704249768 Issued in MI
Practice address
28963 Little Mack Ave
101
Saint Clair Shores, MI 48081-3017
Phone
(586) 447-0700
Fax
(586) 498-0707
NPI assigned
Aug 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704249768 MI Primary

Addresses

Primary practice location

28963 Little Mack Ave
101
Saint Clair Shores, MI 48081-3017

Mailing address

28963 Little Mack Ave
101
Saint Clair Shores, MI 48081-3017
Phone (586) 447-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110308000905 MI Practitioner - Nurse Practitioner 2062694300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Physician Partners CurrentSince Sep 1, 2022 Accepting new patients
Henry Ford Physician Partners CurrentSince Sep 1, 2022 Accepting new patients
Henry Ford Health System CurrentSince Apr 17, 2023 Accepting new patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
Henry Ford Health System CurrentSince Apr 17, 2023 Accepting new patients
Internal Medicine Associates of Mt. Clemens, PC Current Accepting new patients
Alliance Health Professionals, PLLC CurrentSince Mar 30, 2021 Accepting new patients

Locations

2689 Solution Ctr
Chicago, IL 60677

15500 19 Mile Rd
Ste 360
Clinton Twp, MI 48038
Phone (313) 286-8840

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

Interoperability endpoints

  • Direct secure messaging: klyons241437@direct.hfhs.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1134435878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK AVE",
            "address_2": "101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813017",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK AVE",
            "address_2": "101",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813017",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "KIANNA",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704249768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.