Active NPI
Keegan Michael Lyons, MD MPH
- Cytopathology Physician
- Travis Afb, CA
National Provider Identifier
1720060577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cytopathology Physician
- License
- 0101840450
- Practice address
- 101 Bodin Cir
Travis Afb, CA 94535-1809 - Phone
- (707) 423-7829
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 0101840450 | VA | |
| Cytopathology Physician | 207ZC0500X | 0101840450 | VA | Primary |
Addresses
Primary practice location
101 Bodin Cir
Travis Afb, CA 94535-1809
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Phone (210) 975-6855
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101840450 | VA | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1720060577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15301 WARREN SHINGLE RD",
"city": "BEALE AFB",
"state": "CA",
"postal_code": "959031905",
"telephone_number": "210-975-6855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "KEEGAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2023-07-06",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "VA",
"license": "0101840450",
"primary": false
},
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "VA",
"license": "0101840450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.