Carole Lyons, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN126681 Issued in GA

Practice address

172 Follins LN
St Simons Island, GA 31522-4268

Phone

(912) 634-2795

Fax

(912) 638-5636

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402
  NPD (past)
• Pediatrics of Glynn on the Island

  • Pediatrics Physician
  • St Simons Island, GA
  • NPI 1831210657
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245338912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 FOLLINS LN",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224268",
            "telephone_number": "912-634-2795",
            "fax_number": "912-638-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 FOLLINS LN",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224268",
            "telephone_number": "912-634-2795",
            "fax_number": "912-638-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "CAROLE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN126681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00760966B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Lillibridge, MD
• Lily Obstetrics and Gynecology, LLC
• John Alexander Limburg, M.D.
• Live Long Well Care, LLC (Live Long Well Care of Marsh's Edge)
• Matthew M Luce, PHARM.D.
• Savannah E Lyons, DPT, PT
• Macmed LLC
• Victoria Michelle Madray, MD
• Corrie Corrie Mangan
• Margaret F. Carter, MD, PC

• Pediatric Nurse Practitioner in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.