OTIS D LYLES JR. (NPI# 1609439272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609439272 |
| Entity Type | Individual |
| Full Name | OTIS D LYLES JR. |
| Practice Address |
305 Lynn Dr Alton IL 62002-7508 |
| Practice Telephone | 3145817735 |
| Practice Fax Number | 6184665501 |
| Mailing Telephone | 3145817735 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | MO | Transportation Services |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1999 Old Jamestown Rd, Florissant, MO 630336303 | 3145817735 | 6184665501 |
| Street Address |
305 LYNN DR |
| City | ALTON |
| State | IL |
| Zip Code | 62002-7508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902253743 | Ready Transportation, Inc | Non-emergency Medical Transport (VAN) | 401 P Lane, Alton, MO 65606 | 2016-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619426 | Smart Port Care LLC | Non-emergency Medical Transport (VAN) | 152 S 5000w Rd, Kankakee, IL 60901-7902 | 2020-11-03 |
| 1386244721 | Philip Anipah | Non-emergency Medical Transport (VAN) | 7440 Tennessee Dr Apt 211, Willowbrook, IL 60527-2390 | 2020-10-26 |
| 1720687080 | Leron Hargrove-head | Non-emergency Medical Transport (VAN) | 16819 Glen Oaks Dr, Country Club Hills, IL 60478-2147 | 2020-10-19 |
| 1861090045 | Kind Care Illinois | Non-emergency Medical Transport (VAN) | 1617 Westminster Dr Apt 203, Naperville, IL 60563-9226 | 2020-10-11 |
| 1194332213 | Community Medical Transport Ltd | Non-emergency Medical Transport (VAN) | 534 16th St Ste C, Rock Island, IL 61201-8635 | 2020-09-24 |
| 1366058042 | Mary Oluwakemi Adedeji | Non-emergency Medical Transport (VAN) | 409 Carey Ct, Chicago Heights, IL 60411-1646 | 2020-09-18 |
| 1417568577 | Henry Oa Darko | Non-emergency Medical Transport (VAN) | 1830 Carl Dr, Round Lake Beach, IL 60073-1394 | 2020-08-12 |
| 1649881962 | Neneme LLC | Non-emergency Medical Transport (VAN) | 6201 Smokey Ridge Dr, Plainfield, IL 60586-5563 | 2020-08-11 |
| 1023627395 | Impact Medical Transport | Non-emergency Medical Transport (VAN) | 915 Il-106, Barry, IL 62312 | 2020-07-23 |
| 1336767086 | Tawanna Henry | Non-emergency Medical Transport (VAN) | 1755 E 72nd Pl Apt 2, Chicago, IL 60649-2839 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.