Individual provider Active NPI

Vicki J Lyons, M.D.

  • Allergy Physician
  • Ogden, UT
National Provider Identifier
1326013574
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
272784-1205 Issued in UT
Practice address
4403 Harrison Blvd
Suite 4640
Ogden, UT 84403-3271
Phone
(801) 387-4850
Fax
(801) 387-4855
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 272784-1205 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd
Suite 4640
Ogden, UT 84403-3271

Mailing address

4403 Harrison Blvd
Suite 4640
Ogden, UT 84403-3271
Phone (801) 387-4850

Other identifiers 1

IdentifierTypeStateIssuer
P00069425OtherUTRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031125000297 UT Practitioner - Allergy/Immunology 7911801097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Louisiana State University School of Medicine in Shreveport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vicki J Lyons MD PCGroup PAC ID 4486558566, 4 clinicians

Practice addresses (Care Compare)

4403 Harrison Blvd
Suite 4640
Ogden, UT 84403-3304
Phone (801) 387-4850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
272784-1205UTMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vicki J Lyons MD PC Allergy CurrentSince Apr 1, 2003 Accepting new patients

Locations

4403 Harrison Blvd
Ste 464
Ogden, UT 84403

425 E 5350 S
Ste 110
Ogden, UT 84405
Phone (801) 476-0052

4403 Harrison Blvd
Ste 4640
Ogden, UT 84403
Phone (801) 387-4850

Interoperability endpoints

  • Direct secure messaging: vicki.lyons.advancedallergyasthma@aaa.direct.systemedx.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1326013574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE 4640",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-4850",
            "fax_number": "801-387-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD",
            "address_2": "SUITE 4640",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033271",
            "telephone_number": "801-387-4850",
            "fax_number": "801-387-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "VICKI",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "UT",
            "license": "272784-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00069425",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.