Individual provider Active NPI

William Glenn Lyle, M.D.

  • Specialist
  • Raleigh, NC
National Provider Identifier
1700851037
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1112 Dresser CT
Raleigh, NC 27609-7303
Phone
(919) 872-2616
Fax
(919) 872-2771
NPI assigned
Feb 21, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NC Primary

Addresses

Primary practice location

1112 Dresser CT
Raleigh, NC 27609-7303

Mailing address

1112 Dresser CT
Raleigh, NC 27609-7303
Phone (919) 872-2616

Other identifiers 1

IdentifierTypeStateIssuer
8912585MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120203000010 NC Practitioner - Plastic and Reconstructive Surgery 2264581941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000-00259NCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Plastic Surgery Center Inc CurrentSince Jul 1, 1994 Accepting new patients
Raleigh Plastic Surgery Center Specialist CurrentSince Feb 28, 2002 Accepting new patients
Specialists in Plastic Surgery PA Specialist PastSince Nov 27, 2000 Accepting new patients

Locations

1112 Dresser Ct
Raleigh, NC 27609
Phone (919) 872-2616

Interoperability endpoints

  • Direct secure messaging: wglennlyle@rpsci.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700851037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 DRESSER CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097303",
            "telephone_number": "919-872-2616",
            "fax_number": "919-872-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 DRESSER CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097303",
            "telephone_number": "919-872-2616",
            "fax_number": "919-872-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLE",
        "first_name": "WILLIAM",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912585",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.