Active NPI
Kelli Lyon, APRN
- Family Nurse Practitioner
- Sanford, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11023074
- Practice address
- 145 Mayfair CT
Sanford, FL 32771-7707 - Phone
- (317) 502-6236
- NPI assigned
- Jan 18, 2022
- Last updated
- Aug 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11023074 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Pcma Palliative Division LLC | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Current | 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
- 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.
-
dba Pcma Medical Group LLC Sole MBR
- Hospice and Palliative Medicine (Family Medicine) Physician
- Pittsburgh, PA
- NPI 1629585054
FL
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1619105244
-
dba Community Physician Network
- Endocrinology, Diabetes & Metabolism Physician
- Carmel, IN
- NPI 1992396337
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
- Luxottica of America Inc. (LensCrafters #1181)
- Luxottica of America Inc. (Target Optical #2129)
- Luxottica Retail North America Inc (Sears Optical #C1045)
- Rosemarie Lyle
- Mary J Lynn, MS
- Robert Macdonald
- Gianne Macedo Goedert, M.D.
- Machara Chiropractic Inc
- Machara Chiropractic, Inc.
- Sameh Madanieh, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.