Renee Elise Lydiard

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

266838 Issued in AZ

Practice address

4213 E Avalon Dr
Phoenix, AZ 85018-7207

Phone

(602) 692-7810

NPI assigned

Nov 18, 2021

Sex

Female

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

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Banner Alzheimers InstituteGroup PAC ID 8527070101, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Banner Alzheimer'S Institute

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1013966712

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Banner Alzheimer'S Institute

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1730651738

  Single Specialty

  NPD

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1144987793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 E AVALON DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187207",
            "telephone_number": "602-692-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 E AVALON DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187207",
            "telephone_number": "602-692-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYDIARD",
        "first_name": "RENEE",
        "middle_name": "ELISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "266838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LW Care LLC
• David Ly, OD
• Minh Tu Ly, PHARMD
• Melinda Frances Lyall, MD
• Lydia J Cohan MD PC
• Joni Suzanne Lydic, F.N.P.
• Lynn Sokol Lydon, M.D.
• Lauren Lyell, RN
• Nolan Lyle, DPT
• Lyman Orthopedics PLC

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.