Active NPI
Tonya A Lyles, MD
- Pediatrics Physician
- Valley, AL
National Provider Identifier
1215006408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23074
- Practice address
- 4900 20TH Ave
Valley, AL 36854-3549 - Phone
- (334) 756-5137
- Fax
- (334) 756-6523
- NPI assigned
- Nov 6, 2006
- Last updated
- Dec 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23074 | AL | Primary |
| Pediatrics Physician | 208000000X | 049732 | GA |
Addresses
Primary practice location
4900 20TH Ave
Valley, AL 36854-3549
Mailing address
4900 20TH Ave
Valley, AL 36854-3549
Phone (334) 756-5137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009922370 | Medicaid | AL |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23074 | AL | MD | Pediatrics Physician |
| 049732 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Medical Clinic LLC | Pediatrics | Past | Accepting new patients |
| Access Medical Clinic LLC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- tonya.lyles.1@22155.direct.athenahealth.com
- https://api.platform.athenahealth.com/22155/brand/1/csg/1/fhir/r4
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1215006408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 20TH AVE",
"city": "VALLEY",
"state": "AL",
"postal_code": "368543549",
"telephone_number": "334-756-5137",
"fax_number": "334-756-6523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 20TH AVE",
"city": "VALLEY",
"state": "AL",
"postal_code": "368543549",
"telephone_number": "334-756-5137",
"fax_number": "334-756-6523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYLES",
"first_name": "TONYA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "23074",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "049732",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009922370",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valley, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.