Individual provider Active NPI

Daniel Donald Lyons, DC

  • Chiropractor
  • Green Bay, WI
National Provider Identifier
1508990680
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
WI 3306 Issued in WI
Practice address
2920 South Webster
Suite 100
Green Bay, WI 54301-2801
Phone
(920) 347-4884
Fax
(920) 347-4878
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X WI 3306 WI Primary

Addresses

Primary practice location

2920 South Webster
Suite 100
Green Bay, WI 54301-2801

Mailing address

2920 South Webster
Suite 100
Green Bay, WI 54301-2801
Phone (920) 347-4884

Other identifiers 1

IdentifierTypeStateIssuer
38966500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060116000392 WI Practitioner - Chiropractic 9032133210 Reassigns benefits to 1 organization
Practice locations: Green Bay, WI; Mt Horeb, WI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2920 S Webster Ave
Suite 100
Green Bay, WI 54301-1594
Phone (920) 347-4884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WI 3306WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lyons Health, LLC Chiropractor CurrentSince Jul 9, 2008 Accepting new patients
The Wellness Way Green Bay LLC Chiropractor Past Accepting new patients

Locations

2920 S Webster Ave
Ste 100
Green Bay, WI 54301
Phone (920) 347-4884

2920 S Webster Ave
Green Bay, WI 54301
Phone (920) 347-4884

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1508990680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 SOUTH WEBSTER",
            "address_2": "SUITE 100",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012801",
            "telephone_number": "920-347-4884",
            "fax_number": "920-347-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 SOUTH WEBSTER",
            "address_2": "SUITE 100",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012801",
            "telephone_number": "920-347-4884",
            "fax_number": "920-347-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "DANIEL",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "WI 3306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38966500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.