Individual provider Active NPI

Deborah Lyon, M.D.

  • Obstetrics & Gynecology Physician
  • Ft Stewart, GA
National Provider Identifier
1528034832
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME72401 Issued in FL
Practice address
1061 Harmon Ave Ste 1D03
Winn Army Community Hospital
Ft Stewart, GA 31314-5674
Phone
(912) 435-5965
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME72401 FL Primary

Addresses

Primary practice location

1061 Harmon Ave Ste 1D03
Winn Army Community Hospital
Ft Stewart, GA 31314-5674

Mailing address

1061 Harmon Ave Ste 1D03
Winn Army Community Hospital
Ft Stewart, GA 31314-5674
Phone (912) 435-5965

Other identifiers 4

IdentifierTypeStateIssuer
000665893CMedicaidGA
2501911-00MedicaidFL
160030994OtherFLRAILROAD MEDICARE
31455MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110427000666 FL Practitioner - Obstetrics/Gynecology 2062697584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OB Hospitalist Group LLCGroup PAC ID 5193866838, 127 clinicians

Practice addresses (Care Compare)

3625 University S Blvd
Jacksonville, FL 32216-4207
Phone (800) 967-2289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72401FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler OB GYN PA Obstetrics & Gynecology CurrentSince Nov 1, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jun 21, 2017 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Jun 21, 2017 Accepting new patients
Memorial Family Practice Associates, LLC Past Accepting new patients
Juan Larroude MD PA PastSince Nov 1, 2020 Accepting new patients

Locations

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

3100 US Highway 1 S
Ste 1
Saint Augustine, FL 32086
Phone (904) 797-2777

Organizations & group practices 6

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1528034832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE STE 1D03",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL",
            "city": "FT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE STE 1D03",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL",
            "city": "FT STEWART",
            "state": "GA",
            "postal_code": "313145674",
            "telephone_number": "912-435-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME72401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000665893C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2501911-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160030994",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31455",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Stewart, GA

Sources for this page

Verify at the official NPI Registry.