Active NPI
Janeen A Lyche
- Family Nurse Practitioner
- Hagerstown, MD
National Provider Identifier
1538226972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R156248
- Practice address
- 13403 Volvo Way
Medical Suite
Hagerstown, MD 21742-3810 - Phone
- (240) 500-3764
- Fax
- (301) 790-2050
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R156248 | MD | Primary |
Addresses
Primary practice location
13403 Volvo Way
Medical Suite
Hagerstown, MD 21742-3810
Mailing address
13403 Volvo Way
Medical Suite
Hagerstown, MD 21742-3810
Phone (240) 500-3764
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027028800 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R156248 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459987200000",
"number": "1538226972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13403 VOLVO WAY",
"address_2": "MEDICAL SUITE",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217423810",
"telephone_number": "240-500-3764",
"fax_number": "301-790-2050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13403 VOLVO WAY",
"address_2": "MEDICAL SUITE",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217423810",
"telephone_number": "240-500-3764",
"fax_number": "301-790-2050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYCHE",
"first_name": "JANEEN",
"middle_name": "A",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2016-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R156248",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "027028800",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.