Willie J Lyons Jr., LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

11403 Issued in SC

Practice address

300 Berkshire Dr Ste C
Columbia, SC 29223-1859

Phone

(803) 906-0301

NPI assigned

Feb 22, 2024

Sex

Male

Sole proprietor

No

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

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.

• Soda City Therapeutic Massage

  • Massage Therapist
  • Columbia, SC
  • NPI 1033975545
  NPD Authorized official

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1174389688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BENT OAK TRL",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290168380",
            "telephone_number": "719-205-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BERKSHIRE DR STE C",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292231859",
            "telephone_number": "803-906-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "WILLIE",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "11403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carra Lyons, MD
• Daniel Lyons, PT, DPT
• Jeanne Lyons, RBT
• Kimberly Jane Lyons, R.PH.
• Lauren Elizabeth Lyons, PHARMD
• David Bennett Lytch, D.C.
• William Franklin Lytle Jr., M.D.
• M.a.P. II Transport LLC
• M.E. Contracting
• M3 Ventures, LLC

• Massage Therapist in Columbia, SC
• Providers in Columbia, SC by specialty
• Massage Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.