Tony Wayne Lyle, NAVY IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

1061 Uss Tennessee Ave
Kings Bay, GA 31547

Phone

(912) 573-4540

NPI assigned

Jul 16, 2007

Last updated

Jul 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1144429507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 LAKE VICTORIA DR.",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "31548",
            "telephone_number": "912-322-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 USS TENNESSEE AVE",
            "city": "KINGS BAY",
            "state": "GA",
            "postal_code": "31547",
            "telephone_number": "912-573-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLE",
        "first_name": "TONY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "NAVY IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Johnson
• Edward Vincent Kay
• Michael Dennis Lappi
• Eric Windsor Larson Sr., SUBMARINE IDC
• Michael Arnez Leggett, IDC
• Jeffrey Scott Martin, I.D.C
• Julianne Rockett Maynard, RDN, LD
• Odelia Nicole McFadden, PSY.D.
• Sean Thomas Sengiawasa Meadors, SSIDC
• Stephanie Mehr, IDHS

• Independent Duty Corpsman in Kings Bay, GA
• Providers in Kings Bay, GA by specialty
• Independent Duty Corpsman in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.