Lyon Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LYON PHYSICAL THERAPY LLC

Doing business as

Lyon Physical Therapy

Practice address

N3116 S 1 Dr
Wallace, MI 49893-9627

Phone

(906) 309-0158

Fax

(906) 299-5067

NPI assigned

Apr 25, 2022

Last updated

May 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea R Lyon, PT, DPTNPI 1699393983

Title

Owner/Sole Member/PT

Phone

(906) 309-0185

Specialties & licenses 1

Addresses

Other names 1

• Lyon Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI, WI2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea R Lyon, PT, DPT

  • Physical Therapist
  • Marinette, WI
  • NPI 1699393983

  MI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1336883453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 MAPLE AVE UNIT 1021",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434649",
            "telephone_number": "906-309-0158",
            "fax_number": "906-299-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3116 S 1 DR",
            "city": "WALLACE",
            "state": "MI",
            "postal_code": "498939627",
            "telephone_number": "906-309-0158",
            "fax_number": "906-299-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYON PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "LYON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/SOLE MEMBER/PT",
        "authorized_official_telephone_number": "906-309-0185",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lyon Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lorianna Peura

• Physical Therapist in Wallace, MI
• Providers in Wallace, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.