Individual provider Active NPI

Kelli Lyon, APRN

  • Family Nurse Practitioner
  • Sanford, FL
National Provider Identifier
1922750264
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11023074 Issued in FL
Practice address
145 Mayfair CT
Sanford, FL 32771-7707
Phone
(317) 502-6236
NPI assigned
Jan 18, 2022
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11023074 FL Primary
Family Nurse Practitioner 363LF0000X 28197195A IN

Addresses

Primary practice location

145 Mayfair CT
Sanford, FL 32771-7707

Mailing address

145 Mayfair CT
Sanford, FL 32771-7707
Phone (317) 502-6236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220216001549 IN Practitioner - Nurse Practitioner 5294128195 Reassigns benefits to 1 organization
I20250811001351 FL Practitioner - Nurse Practitioner 5294128195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Pcma Palliative Division LLCGroup PAC ID 1456613637, 72 clinicians

Practice addresses (Care Compare)

4833 Fruitville Rd
Unit 101
Sarasota, FL 34232-1885
Phone (878) 201-3312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11023074FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Feb 15, 2022 Accepting new patients
Pcma Palliative Division LLC CurrentSince Jun 7, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Feb 15, 2022 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7910 E Washington St
Indianapolis, IN 46219
Phone (317) 355-1330

7910 E Washington St
Ste 110
Indianapolis, IN 46219
Phone (317) 355-3200

2000 Cliffmine Rd
Ste 500
Pittsburgh, PA 15275
Phone (724) 766-0025

Interoperability endpoints

  • Direct secure messaging: khackler7675@ecommunitydirect.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1922750264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MAYFAIR CT",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717707",
            "telephone_number": "317-502-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MAYFAIR CT",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717707",
            "telephone_number": "317-502-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "KELLI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11023074",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28197195A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

Verify at the official NPI Registry.