Jerry Jason Lyles, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

602664841 Issued in WA

Practice address

100 Eastside Drive
Georgetown, KY 40324

Phone

(502) 868-0097

NPI assigned

Jan 26, 2007

Last updated

Feb 10, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1457407801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EASTSIDE DRIVE",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "502-868-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EASTSIDE DRIVE",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "502-868-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES",
        "first_name": "JERRY",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "602664841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Michelle Long, MED, BCBA, LBA
• Anthony Jay Lopez, MD
• Robert S Louallen
• LP Georgetown LLC (Signature HealthCARE of Georgetown)
• Amelia Carol Luckett
• Lyndsay Dixon Nutrition LLC (Southern Roots Dietitian)
• Benjamin P Lyon, M.D.
• Rebecca Lyons, CRNA
• M. Suzanne Ahnquist, D.M.D.
• Caleb Mackey, LPCC

• Chiropractor in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.