NPIMap

Individual provider Active NPI

Lewis Clinton Lyons III, M.D.

  • Vascular Surgery Physician
  • Mobile, AL
National Provider Identifier
1700052966
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
39358 Issued in AL
Practice address
1855 Spring Hill Ave
Mobile, AL 36607-2301
Phone
(251) 471-3544
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 39358 AL Primary
Vascular Surgery Physician 2086S0129X E9259 AR

Addresses

Primary practice location

1855 Spring Hill Ave
Mobile, AL 36607-2301

Mailing address

1855 Spring Hill Ave
Mobile, AL 36607-3592
Phone (251) 471-3544

Other practice location 1

4301 W Markham St # 520
Little Rock, AR 72205-7101
Phone (501) 686-6175

Other names 1

  • Trey Lyons Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150730011621 AR Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Family Practice 8426375619 Reassigns benefits to 3 organizations
I20200414003280 AL Practitioner - Vascular SurgeryPractitioner - General Surgery 8426375619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Arkansas College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Cardio-Thoracic and Vascular Surgical Associates LLCGroup PAC ID 4981936796, 23 clinicians

Practice addresses (Care Compare)

1855 Spring Hill Ave
Mobile, AL 36607-2301
Phone (251) 471-3544

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)35
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E9259ARMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Childrens Hospital CurrentSince Sep 1, 2015 Accepting new patients
Arkansas Children's Hospital CurrentSince Sep 1, 2015 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 1, 2015 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2015 Accepting new patients
Cardio-Thoracic & Vascular Surgical Associates, P.C. Vascular Surgery CurrentSince Apr 9, 2020 Accepting new patients
University of Arkansas for Medical Sciences Surgery CurrentSince Jul 1, 2015 Accepting new patients

Locations

1770 N Alston St
Foley, AL 36535
Phone (251) 471-3544

1855 Spring Hill Ave
Mobile, AL 36607
Phone (251) 471-3544

4301 W Markham St
#520
Little Rock, AR 72205
Phone (501) 686-5205

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

Interoperability endpoints

  • Direct secure messaging: llyons87863@directinfirmaryhealth.org

Organizations & group practices 7

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 8

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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1700052966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073592",
            "telephone_number": "251-471-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072301",
            "telephone_number": "251-471-3544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 520",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "LEWIS",
        "middle_name": "CLINTON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AL",
            "license": "39358",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "E9259",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "LYONS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.