Individual provider Active NPI

Timothy Lyons, MD

  • Family Medicine Physician
  • Jerseyville, IL
National Provider Identifier
1164636825
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036116621 Issued in IL
Practice address
390 Maple Summit Rd
Jerseyville, IL 62052-2000
Phone
(618) 498-2101
Fax
(618) 498-8153
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036116621 IL Primary

Addresses

Primary practice location

390 Maple Summit Rd
Jerseyville, IL 62052-2000

Mailing address

390 Maple Summit Rd
Jerseyville, IL 62052-2000
Phone (618) 498-7518

Other practice location 1

414 S State St
Roodhouse, IL 62082-1544
Phone (217) 589-4383

Other practice location 2

2 Myrtle Lane
Hardin, IL 62047
Phone (618) 576-9407

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address tlyons@jch.cernerdirect.com Health Information Exchange (HIE)
Direct Messaging Address tlyons@jch.cernerdirect.com Health Information Exchange (HIE)
Direct Messaging Address tlyons@jch.cernerdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070920000776 IL Practitioner - Family Practice 2668566613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Practice addresses (Care Compare)

2 Myrtle
Hardin, IL 62047-1002
Phone (618) 576-9407

270 Maple Summit Rd
Jerseyville, IL 62052-2004
Phone (618) 498-7108

390 Maple Summit Rd
Jerseyville, IL 62052-2000
Phone (618) 498-2101

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

414 S State St
Roodhouse, IL 62082-1544
Phone (217) 589-4383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036116621ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey Community Hospital Current Accepting new patients
Jersey Community Hospital Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Jersey Community Hospital District Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
Jersey Community Hospital Past Accepting new patients
Jersey Community Hospital Family Medicine Past Accepting new patients

Locations

103 McCausland St
Carlinville, IL 62626
Phone (217) 854-2623

2 Myrtle
Hardin, IL 62047
Phone (618) 498-7383

390 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-2101

400 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-6402

414 S State St
Roodhouse, IL 62082
Phone (217) 589-4383

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1164636825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522000",
            "telephone_number": "618-498-7518",
            "fax_number": "618-498-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522000",
            "telephone_number": "618-498-2101",
            "fax_number": "618-498-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 S State St",
            "address_purpose": "LOCATION",
            "city": "Roodhouse",
            "state": "IL",
            "postal_code": "620821544",
            "country_code": "US",
            "telephone_number": "217-589-4383",
            "fax_number": "217-589-4409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Myrtle Lane",
            "address_purpose": "LOCATION",
            "city": "Hardin",
            "state": "IL",
            "postal_code": "62047",
            "country_code": "US",
            "telephone_number": "618-576-9407",
            "fax_number": "618-576-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036116621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlyons@jch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "HIE JERSEY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Myrtle Lane",
            "city": "Hardin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "62047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlyons@jch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "HIE JERSEY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "390 Maple Summit Rd",
            "city": "Jerseyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620522000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlyons@jch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "HIE JERSEY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "414 S State St",
            "city": "Roodhouse",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620821544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jerseyville, IL

Sources for this page

Verify at the official NPI Registry.