Individual provider Active NPI

Marquita Pleshette Lyons, CPNP

  • Pediatric Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1225107048
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0050-01540 Issued in NC
Practice address
1708 Trawick Rd
Suite 111
Raleigh, NC 27604-3897
Phone
(919) 250-3478
Fax
(919) 250-6272
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0050-01540 NC Primary

Addresses

Primary practice location

1708 Trawick Rd
Suite 111
Raleigh, NC 27604-3897

Mailing address

118 Station Dr
Morrisville, NC 27560-9247
Phone (919) 402-7216

Other identifiers 1

IdentifierTypeStateIssuer
7005932MedicaidNC

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
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0050-01540NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maruthi Pediatrics PLLC PastSince Sep 6, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1225107048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 STATION DR",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275609247",
            "telephone_number": "919-402-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 TRAWICK RD",
            "address_2": "SUITE 111",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043897",
            "telephone_number": "919-250-3478",
            "fax_number": "919-250-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "MARQUITA",
        "middle_name": "PLESHETTE",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "0050-01540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005932",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.