Individual provider Active NPI

Kenneth Anthony Lyons, M.D.

  • Internal Medicine Physician
  • Marshalltown, IA
National Provider Identifier
1932199734
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21610 Issued in IA
Practice address
312 E Main St
Marshalltown, IA 50158-1888
Phone
(641) 752-0654
Fax
(641) 844-2206
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21610 IA Primary

Addresses

Primary practice location

312 E Main St
Marshalltown, IA 50158-1888

Mailing address

312 E Main St
Marshalltown, IA 50158-1888
Phone (641) 752-0654

Other identifiers 1

IdentifierTypeStateIssuer
1182220MedicaidIA

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 Medicine

State licenses

LicenseStateTypeSpecialty
21610IAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1932199734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501581888",
            "telephone_number": "641-752-0654",
            "fax_number": "641-753-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501581888",
            "telephone_number": "641-752-0654",
            "fax_number": "641-844-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "KENNETH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "21610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1182220",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.