Active NPI
Richard C Lyons, M.D.
- Otolaryngology Physician
- Winooski, VT
National Provider Identifier
1740287283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 042-0005615
- Practice address
- 389 E Allen St
Winooski, VT 05404-1560 - Phone
- (802) 655-1314
- Fax
- (802) 655-2895
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 042-0005615 | VT | Primary |
Addresses
Primary practice location
389 E Allen St
Winooski, VT 05404-1560
Mailing address
389 E Allen St
Winooski, VT 05404-1560
Phone (802) 655-1314
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004622 | Medicaid | VT | |
| 041092506 | Other | TRICARE | |
| 5293001 | Other | VT | VERMONT MANAGED CARE |
| VT4622 | Other | VT | VT BCBS |
| 04V006 | Other | MVP |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0005615 | VT | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381795200000",
"number": "1740287283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "389 E ALLEN ST",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054041560",
"telephone_number": "802-655-1314",
"fax_number": "802-655-2895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "389 E ALLEN ST",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054041560",
"telephone_number": "802-655-1314",
"fax_number": "802-655-2895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "RICHARD",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2013-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "VT",
"license": "042-0005615",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004622",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "041092506",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VERMONT MANAGED CARE",
"identifier": "5293001",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VT BCBS",
"identifier": "VT4622",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "04V006",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Winooski, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.