Active NPI
Mike Lyons
- Adult Medicine Physician
- Middle River, MD
National Provider Identifier
1528112281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- D0055426
- Practice address
- 9601 Pulaski Park Dr
Suite 416
Middle River, MD 21220-1409 - Phone
- (410) 933-5678
- NPI assigned
- Jan 22, 2007
- Last updated
- Jun 12, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | D0055426 | MD | Primary |
Addresses
Primary practice location
9601 Pulaski Park Dr
Suite 416
Middle River, MD 21220-1409
Mailing address
9601 Pulaski Park Dr
Suite 416
Middle River, MD 21220-1409
Phone (410) 933-5678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150702000269 | MD | Practitioner - Family Practice | 1153633250 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0055426 | MD | MD | Adult Medicine Physician |
Interoperability endpoints
- mlyons1174514@meritus.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1528112281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9601 PULASKI PARK DR",
"address_2": "SUITE 416",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212201409",
"telephone_number": "410-933-5678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 PULASKI PARK DR",
"address_2": "SUITE 416",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212201409",
"telephone_number": "410-933-5678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "MIKE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "MD",
"license": "D0055426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middle River, MD
- Long Integrated Psychiatric Services LLC
- Long Integrated Psychiatric Services LLC
- Angela Desiree Long, FNP-BC, PMHNP-BC
- Dorcas Lwanga, RDN, LDN
- Laryan Lynch
- Antonia O F L Maccormack
- Elizabeth Mary Mackey, CRNA
- Suhas Madhiraju, MD
- Malik Home Care LLC
- Manifest Wellness Services LLC (Manifest Weight Loss: Lose Weight, Love Life, No Restrictions.)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.