Active NPI
John W. Lyons
- Community Health Worker
- Marquette, MI
National Provider Identifier
1750007977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1200 Wright St
Marquette, MI 49855-1837 - Phone
- (906) 936-0906
- NPI assigned
- Oct 19, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
1200 Wright St
Marquette, MI 49855-1837
Mailing address
1200 Wright St
Marquette, MI 49855-1837
Phone (906) 936-0906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172VOOOOOX | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | johnl@upsail.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1750007977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 WRIGHT ST",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498551837",
"telephone_number": "906-936-0906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 WRIGHT ST",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498551837",
"telephone_number": "906-936-0906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "JOHN",
"middle_name": "W.",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-19",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172VOOOOOX",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "johnl@upsail.org",
"affiliation": "N",
"address_1": "1200 Wright St",
"city": "Marquette",
"state": "MI",
"country_code": "US",
"postal_code": "498551837",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marquette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.