Individual provider Active NPI

George R Lyons, MD

  • Neurology Physician
  • Boise, ID
National Provider Identifier
1386630465
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
M-6224 Issued in ID
Practice address
1072 N Liberty St
Suite 303
Boise, ID 83704-2800
Phone
(208) 367-2800
Fax
(208) 367-7111
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X M6224 ID
Neurology Physician 2084N0400X M-6224 ID Primary

Addresses

Primary practice location

1072 N Liberty St
Suite 303
Boise, ID 83704-2800

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026
Phone (208) 367-5170

Other identifiers 1

IdentifierTypeStateIssuer
003798900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20040419001544 ID Practitioner - NeurologyPractitioner - Psychiatry 6901891886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
Pennsylvania State University College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

1072 N Liberty St
Boise, ID 83704-8708

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M6224IDMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 13, 2014 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Neurology Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc Neurology CurrentSince Jan 13, 2014 Accepting new patients

Locations

999 N Curtis Rd
Ste 506
Boise, ID 83706
Phone (208) 367-2800

1072 N Liberty St
Ste 303
Boise, ID 83704
Phone (208) 302-4200

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

1072 N Liberty St
Ste 203
Boise, ID 83704
Phone (208) 302-5800

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: glyons1563295@direct.trinity-health.org

Organizations & group practices 3

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 6

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1386630465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N LIBERTY ST",
            "address_2": "SUITE 303",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837042800",
            "telephone_number": "208-367-2800",
            "fax_number": "208-367-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "GEORGE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ID",
            "license": "M6224",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ID",
            "license": "M-6224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003798900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.