Individual provider Active NPI

Justin Cole Lyttle, DMPNA CRNA

  • Certified Registered Nurse Anesthetist
  • Charleston, WV
National Provider Identifier
1205490919
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019906 Issued in OH
Practice address
501 Morris St
Charleston, WV 25301-1326
Phone
(304) 388-5432
NPI assigned
Apr 29, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.019906 OH Primary

Addresses

Primary practice location

501 Morris St
Charleston, WV 25301-1326

Mailing address

501 Morris St
Charleston, WV 25301-1326
Phone (304) 647-6006

Other practice location 1

1220 Lee St E
Charleston, WV 25301-1863
Phone (304) 388-1800

Other practice location 2

3200 MacCorkle Ave SE
Charleston, WV 25304
Phone (304) 388-5432

Other practice location 3

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-5432

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address anesthesia.providers@mmhs.medicity.net
Direct Messaging Address anesthesia.providers@mmhs.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230901002601 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032444385 Reassigns benefits to 1 organization
I20241218002131 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032444385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
81.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
7438NCMDOccupational Therapy Assistant
APRN.CRNA.019906OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Jul 19, 2023 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Nov 4, 2024 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Nov 4, 2024 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Jul 19, 2023 Accepting new patients

Locations

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

300 E Wendover Ave
Fl 2
Greensboro, NC 27401
Phone (336) 663-5219

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1106 Colegate Dr
Marietta, OH 45750
Phone (740) 374-7700

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

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 1

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1205490919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-647-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-388-5432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 Lee St E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011863",
            "country_code": "US",
            "telephone_number": "304-388-1800",
            "fax_number": "304-388-1825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "25304",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023351",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYTTLE",
        "first_name": "JUSTIN",
        "middle_name": "COLE",
        "credential": "DMPNA CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2025-09-11",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anesthesia.providers@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "1106 Colegate Dr",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anesthesia.providers@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "401 Matthew St",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.