Individual provider Active NPI

Carly E Lyons, M.D.

  • Pediatrics Physician
  • College Station, TX
National Provider Identifier
1841565116
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q8292 Issued in TX
Practice address
800 Scott and White Dr
College Station, TX 77845-6440
Phone
(979) 207-4000
Fax
(979) 207-4562
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 47764 KY
Pediatrics Physician 208000000X Q8292 TX Primary

Addresses

Primary practice location

800 Scott and White Dr
College Station, TX 77845-6440

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other names 1

  • Carly E Jones Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clyons217213@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20191231000452 TX Practitioner - Pediatric Medicine 9537593496 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47764KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Pediatrics Current Accepting new patients
Scott & White Clinic Pediatrics CurrentSince Nov 12, 2019 Accepting new patients
Scott & White Clinic Pediatrics CurrentSince Nov 12, 2019 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

800 Scott and White Dr
College Station, TX 77845
Phone (979) 207-3300

1700 University Dr E
Fl 2
College Station, TX 77840
Phone (979) 361-3300

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

1700 University Dr E
College Station, TX 77840
Phone (979) 691-3300

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: clyons217213@direct.sw.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1841565116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCOTT AND WHITE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456440",
            "telephone_number": "979-207-4000",
            "fax_number": "979-207-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "CARLY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "47764",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q8292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clyons217213@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Scott and White Dr",
            "city": "College Station",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778456440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "JONES",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.