NPIMap

Individual provider Active NPI

Lacey Dooley Lyle, F.N.P.

  • Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1215356464
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024171601 Issued in VA
Practice address
5839 Harbour View Blvd Ste 201
Suffolk, VA 23435-3797
Phone
(757) 967-0676
Fax
(757) 967-0675
NPI assigned
Apr 15, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024171601 VA Primary
Family Nurse Practitioner 363LF0000X 0024171601 VA

Addresses

Primary practice location

5839 Harbour View Blvd Ste 201
Suffolk, VA 23435-3797

Mailing address

150 Burnetts Way Ste 320
Suffolk, VA 23434-8288
Phone (757) 934-1900

Other practice location 1

150 Burnetts Way
Suite 320
Suffolk, VA 23434-8168
Phone (757) 934-1900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lacey.lyle@suffolkneuro.com.directbygreenway.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908002608 VA Practitioner - Nurse Practitioner 0749409688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Associates of Suffolk PLLCGroup PAC ID 0244373942, 4 clinicians

Practice addresses (Care Compare)

5839 Harbour View Blvd
Suite 201
Suffolk, VA 23435-3797
Phone (757) 967-0676

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024171601VAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lacey.lyle@suffolkneuro.directbygreenway.com

Organizations & group practices 1

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215356464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BURNETTS WAY STE 320",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348288",
            "telephone_number": "757-934-1900",
            "fax_number": "757-925-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5839 HARBOUR VIEW BLVD STE 201",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353797",
            "telephone_number": "757-967-0676",
            "fax_number": "757-967-0675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Burnetts Way",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348168",
            "country_code": "US",
            "telephone_number": "757-934-1900",
            "fax_number": "757-925-6719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYLE",
        "first_name": "LACEY",
        "middle_name": "DOOLEY",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024171601",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lacey.lyle@suffolkneuro.com.directbygreenway.com",
            "affiliation": "N",
            "endpointDescription": "Lacey Lyle, FNP",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5839 Harbour View Blvd Ste 201",
            "city": "Suffolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234353797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.