KELLY LYONS – Audiologist, NPI 1508313453

KELLY LYONS is a healthcare provider. based in Grand rapids, Michigan. specializing in QUALIFIED AUDIOLOGIST. They hold a License No. 1601000745 (MI). The NPI Number for KELLY LYONS is 1508313453

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
KELLY LYONS
NPI
1508313453
Phone
Not provided
Address
961 4 MILE RD NW
Enumeration Date
8 September 2016
Last Update Date
8 September 2016

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6167846299
Graduation Year
2016 (10 years ago)
PAC ID
3173857588
Group Practice PAC ID
9032277199
Professional Enrollment ID
I20190618003133
Address ID
MI488382138GR403XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

302 QUALIFIED AUDIOLOGIST in MI

Provider Addresses for KELLY LYONS

  • 961 4 MILE RD NW

    GRAND RAPIDS, MI 495448252

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-06-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190618003133IQualified AudiologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49544)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9032277199View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELLY LYONS?
KELLY LYONS — NPI 1508313453 — is the standard way to identify this listing.
Can I rely on KELLY LYONS being an active provider?
As of the registry snapshot, KELLY LYONS is marked active.
What is KELLY LYONS best known for clinically?
Directory data describes KELLY LYONS with Audiologist. Clinical services aligned with this taxonomy classification.
What area does KELLY LYONS serve?
KELLY LYONS's listing highlights Grand Rapids, Michigan; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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