Individual provider Active NPI

Mikayla Lyons, APRN

  • Nurse Practitioner
  • Springfield, OH
National Provider Identifier
1902424930
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0031475 Issued in OH
Practice address
2253 Olympic St Ste B
Springfield, OH 45503-2736
Phone
(937) 419-0920
Fax
(937) 717-1663
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.430631 OH
Family Nurse Practitioner 363LF0000X APRN.CNP. OH
Nurse Practitioner 363L00000X APRN.CNP.0031475 OH Primary

Addresses

Primary practice location

2253 Olympic St Ste B
Springfield, OH 45503-2736

Mailing address

2253 Olympic St Ste B
Springfield, OH 45503-2736
Phone (937) 419-0920

Other practice location 1

474 N Yellow Springs St
Springfield, OH 45504-2463
Phone (937) 399-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212000696 OH Practitioner - Nurse Practitioner 0941679187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Surgical Associates, Inc.Group PAC ID 3577566371, 26 clinicians
Encore Clinical Services LLCGroup PAC ID 5991177313, 49 clinicians
Ohio Wound Care Associates LLCGroup PAC ID 7719393032, 17 clinicians

Practice addresses (Care Compare)

12301 Ridge Rd
North Royalton, OH 44133-3744
Phone (440) 652-8748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0031475OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Wound Care Associates LLC Nurse Practitioner CurrentSince Dec 1, 2025 Accepting new patients
Encore Clinical Services LLC Nurse Practitioner CurrentSince Aug 22, 2025 Accepting new patients
Cleveland Surgical Associates, Inc. Nurse Practitioner CurrentSince Aug 22, 2025 Accepting new patients
Lake Effect Health Nurse Practitioner Current Accepting new patients

Locations

12301 Ridge Rd
North Royalton, OH 44133
Phone (216) 331-6750

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1902424930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 OLYMPIC ST STE B",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032736",
            "telephone_number": "937-419-0920",
            "fax_number": "937-717-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 OLYMPIC ST STE B",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032736",
            "telephone_number": "937-419-0920",
            "fax_number": "937-717-1663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "474 N Yellow Springs St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455042463",
            "country_code": "US",
            "telephone_number": "937-399-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "MIKAYLA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.430631",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0031475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.