Active NPI
Douglas Lyons, D.O.
- Family Medicine Physician
- Fort Hall, ID
National Provider Identifier
1881608644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- O-328
- Practice address
- Mission Road
Fort Hall, ID 83203-0717 - Phone
- (208) 238-5456
- Fax
- (208) 238-5465
- NPI assigned
- Jul 28, 2006
- Last updated
- Jul 19, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | O-328 | ID | Primary |
Addresses
Primary practice location
Mission Road
Fort Hall, ID 83203-0717
Mailing address
Mission Road
Fort Hall, ID 83203-0717
Phone (208) 238-5427
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O-328 | ID | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1881608644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MISSION ROAD",
"city": "FORT HALL",
"state": "ID",
"postal_code": "832030717",
"telephone_number": "208-238-5427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MISSION ROAD",
"city": "FORT HALL",
"state": "ID",
"postal_code": "832030717",
"telephone_number": "208-238-5456",
"fax_number": "208-238-5465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "O-328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hall, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.