Individual provider Active NPI

Nancy Lynn Stevenson-Lyon, ATC

  • Athletic Trainer
  • Newport, VT
National Provider Identifier
1902027402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
104-0000011 Issued in VT
Practice address
209 Veterans Ave.
Newport, VT 05855
Phone
(802) 334-7921
Fax
(802) 334-1618
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 104-0000011 VT Primary

Addresses

Primary practice location

209 Veterans Ave.
Newport, VT 05855

Mailing address

140 Valley Rd
Derby Line, VT 05830-8934
Phone (802) 895-4379

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

State licenses

LicenseStateTypeSpecialty
104-0000011VTMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Deering Counseling LLC PastSince Jun 9, 2024 Accepting new patients
Kingdom Counseling LLC Past Accepting new patients

Organizations & group practices 2

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902027402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 VALLEY RD",
            "city": "DERBY LINE",
            "state": "VT",
            "postal_code": "058308934",
            "telephone_number": "802-895-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 VETERANS AVE.",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-334-7921",
            "fax_number": "802-334-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON-LYON",
        "first_name": "NANCY",
        "middle_name": "LYNN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104-0000011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.