Individual provider Active NPI

John Benton Lyon, M.D.

  • Specialist
  • Laurel, MS
National Provider Identifier
1336208305
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
17566 Issued in MS
Practice address
1431 W 10TH St
Suite 2
Laurel, MS 39440-2626
Phone
(601) 649-2450
Fax
(601) 649-0556
NPI assigned
Dec 6, 2006
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 17566 MS Primary

Addresses

Primary practice location

1431 W 10TH St
Suite 2
Laurel, MS 39440-2626

Mailing address

PO Box 1965
Laurel, MS 39441-1965
Phone (601) 649-2450

Other practice location 1

705 Sawmill Rd
Laurel, MS 39440-3937
Phone (601) 649-2450

Other practice location 2

2024 15th St Ste 5D
Meridian, MS 39301-4130
Phone (601) 553-2100

Other practice location 3

450 5th Ave SW
Magee, MS 39111-3960
Phone (601) 649-2450

Other identifiers 1

IdentifierTypeStateIssuer
000125873MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050610000060 MS Practitioner - Ophthalmology 0749178416 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Georgia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Vision Center PLLCGroup PAC ID 2668415043, 2 clinicians

Practice addresses (Care Compare)

1431 W 10TH St
Laurel, MS 39440-2626
Phone (601) 649-2450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.96 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery226
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17566MSMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Vision Clinic, P.a. CurrentSince Jan 1, 2010 Accepting new patients
Professional Eyecare Associates of Yazoo City, PA CurrentSince May 1, 2017 Accepting new patients
Advanced Vision Center PLLC CurrentSince Mar 2, 2005 Accepting new patients
Family Vision Clinic, Inc. Past Accepting new patients
Lindstrom Eye & Laser Center, P.a. Past Accepting new patients

Locations

1185 Hart St
Canton, MS 39046
Phone (601) 859-3464

1431 W 10th St
Laurel, MS 39440
Phone (601) 649-1437

1431 W 10th St
Ste 2
Laurel, MS 39440
Phone (601) 649-2450

705 Sawmill Rd
Laurel, MS 39440
Phone (601) 649-1437

450 5th Ave SW
Magee, MS 39111
Phone (601) 649-2450

2024 15th St
Ste 5D
Meridian, MS 39301
Phone (601) 553-2100

728 E Fifteenth St
Yazoo City, MS 39194
Phone (662) 332-3325

Interoperability endpoints

  • Direct secure messaging: jlyon@avc.emadirect.md

Organizations & group practices 6

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 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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1336208305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1965",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394411965",
            "telephone_number": "601-649-2450",
            "fax_number": "601-649-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 W 10TH ST",
            "address_2": "SUITE 2",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402626",
            "telephone_number": "601-649-2450",
            "fax_number": "601-649-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Sawmill Rd",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394403937",
            "country_code": "US",
            "telephone_number": "601-649-2450",
            "fax_number": "601-649-0556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2024 15th St Ste 5D",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014130",
            "country_code": "US",
            "telephone_number": "601-553-2100",
            "fax_number": "601-553-2104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 5th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Magee",
            "state": "MS",
            "postal_code": "391113960",
            "country_code": "US",
            "telephone_number": "601-649-2450",
            "fax_number": "601-649-0556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYON",
        "first_name": "JOHN",
        "middle_name": "BENTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "17566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000125873",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.