Individual provider Active NPI

Kathleen Kelly Lyon, NP

  • Adult Health Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1174783658
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
301743 Issued in NY
Practice address
24 Research Way Ste 500
East Setauket, NY 11733-3470
Phone
(631) 444-6279
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 301743 NY Primary

Addresses

Primary practice location

24 Research Way Ste 500
East Setauket, NY 11733-3470

Mailing address

24 Research Way Ste 500
East Setauket, NY 11733-3470
Phone (631) 444-6279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1174783658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY STE 500",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333470",
            "telephone_number": "631-444-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RESEARCH WAY STE 500",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333470",
            "telephone_number": "631-444-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY LYON",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; 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.