NPIMap

Organization Active NPI

Lyerly Baptist Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1740515006
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LYERLY BAPTIST INC
Practice address
836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340
Phone
(904) 388-6518
Fax
(904) 384-1005
NPI assigned
Oct 5, 2009
Last updated
Mar 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
Tyrone McCloud
Title
Executive Director
Phone
(904) 388-6518

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X

Addresses

Primary practice location

836 Prudential Dr Ste 1400
Jacksonville, FL 32207-8340

Mailing address

PO Box 746647
Atlanta, GA 30374-6647
Phone (904) 202-2092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060111001171 FL Part B Supplier - Clinic/Group Practice 9830112226 Receives reassigned benefits from 77 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fernandina Beach, FL; Yulee, FL; Ponte Vedra, FL; Jacksonville Beach, FL; Jacksonville, FL; Fleming Island, FL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

800 Prudential Dr
Ste 1100
Jacksonville, FL 32207
Phone (904) 338-6518

836 Prudential Dr
Ste 1601
Jacksonville, FL 32207
Phone (904) 396-2400

1577 Roberts Dr
Ste 120
Jax Bch, FL 32250
Phone (866) 600-2778

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1740515006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746647",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746647",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078340",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYERLY BAPTIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "MCCLOUD",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-388-6518"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.