Active NPI
Kelly Lyon, RN
- Ambulatory Women's Health Care Registered Nurse
- Sacramento, CA
National Provider Identifier
1265835466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Women's Health Care Registered Nurse
- License
- 835719
- Practice address
- 1442 Ethan Way
Suite 200
Sacramento, CA 95825-2231 - Phone
- (916) 482-4856
- NPI assigned
- Oct 1, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | 835719 | CA | Primary |
Addresses
Primary practice location
1442 Ethan Way
Suite 200
Sacramento, CA 95825-2231
Mailing address
1442 Ethan Way
Suite 200
Sacramento, CA 95825-2231
Phone (916) 482-4856
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 835719 | CA | MD | Ambulatory Women's Health Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412121600000",
"number": "1265835466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1442 ETHAN WAY",
"address_2": "SUITE 200",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958252231",
"telephone_number": "916-482-4856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1442 ETHAN WAY",
"address_2": "SUITE 200",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958252231",
"telephone_number": "916-482-4856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYON",
"first_name": "KELLY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-01",
"last_updated": "2014-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "CA",
"license": "835719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.