Individual provider Active NPI

Frank Lyerla, PHD, RN

  • Registered Nurse
  • Bethalto, IL
National Provider Identifier
1366848772
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
149171 Issued in MO
Practice address
745 Homm St
Bethalto, IL 62010-1715
Phone
(618) 972-4820
NPI assigned
Nov 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 149171 MO Primary
Registered Nurse 163W00000X 041.290018 IL

Addresses

Primary practice location

745 Homm St
Bethalto, IL 62010-1715

Mailing address

745 Homm St
Bethalto, IL 62010-1715
Phone (618) 972-4820

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
Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.290018ILMDRegistered Nurse
149171MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1366848772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 HOMM ST",
            "city": "BETHALTO",
            "state": "IL",
            "postal_code": "620101715",
            "telephone_number": "618-972-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 HOMM ST",
            "city": "BETHALTO",
            "state": "IL",
            "postal_code": "620101715",
            "telephone_number": "618-972-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYERLA",
        "first_name": "FRANK",
        "credential": "PHD, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "149171",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.290018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethalto, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.