Individual provider Active NPI

Melanie A Lyon, FNP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1699436592
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704259710 Issued in MI
Practice address
330 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1267
Phone
(616) 752-6235
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704259710 MI Primary

Addresses

Primary practice location

330 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1267

Mailing address

330 E Beltline Ave NE Ste 100
Grand Rapids, MI 49506-1267
Phone (616) 752-6235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220219000107 MI Practitioner - Nurse Practitioner 2365836236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Associates of West Michigan PCGroup PAC ID 2466348644, 20 clinicians

Practice addresses (Care Compare)

330 E Beltline Ave NE
Suite 100
Grand Rapids, MI 49506-1267
Phone (616) 752-6235

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Holland Hospital Hospital, Holland, MI, CCN 230072
  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704259710MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Associates of West Michigan PC CurrentSince Jan 10, 2022 Accepting new patients
Rai Care Centers of Holland, LLC PastSince Jan 10, 2022 Accepting new patients

Locations

330 E Beltline Ave NE
Ste 100
Grand Rapids, MI 49506
Phone (616) 752-6235

649 Hastings Ave
Holland, MI 49423
Phone (616) 392-3263

Interoperability endpoints

  • Direct secure messaging: mlyon36538@direct.acumenmd.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1699436592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061267",
            "telephone_number": "616-752-6235",
            "fax_number": "616-752-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061267",
            "telephone_number": "616-752-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "MELANIE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704259710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.