Active NPI
Jadah Simone Lyons
- Pharmacist
- Ruston, LA
National Provider Identifier
1508784018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.026292
- Practice address
- 108 W California Ave
Ruston, LA 71270-5014 - Phone
- (318) 255-1811
- NPI assigned
- Jul 10, 2026
- Last updated
- Jul 10, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.026292 | LA | Primary |
Addresses
Primary practice location
108 W California Ave
Ruston, LA 71270-5014
Mailing address
555 Concordia Park Dr
Vidalia, LA 71373-3732
Phone (601) 870-3183
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1508784018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 CONCORDIA PARK DR",
"city": "VIDALIA",
"state": "LA",
"postal_code": "713733732",
"telephone_number": "601-870-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W CALIFORNIA AVE",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705014",
"telephone_number": "318-255-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "JADAH",
"middle_name": "SIMONE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-07-10",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.026292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.