SAMANTHA DANIELLE LYON
NPI 1487262630
Psychologist - Clinical in Johnson City, TN

Q: What is Samantha Lyon's NPI number?

The NPI number for Samantha Lyon is 1487262630. It was assigned to this individual provider in the NPPES registry on July 14, 2020.

Q: What is Samantha Lyon's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Lyon was last updated on January 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2020PECOS Enrolled

1043 JACK VEST DR, JOHNSON CITY, TN 37614(423) 439-4044 Get Directions Write a Review

NPPES record last updated: January 18, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 19, 2022, Jul 14, 2020 (2 updates tracked since 2020).

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About Samantha Danielle Lyon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA DANIELLE LYON (NPI 1487262630) is an individual clinical provider in Johnson City, Tennessee, licensed in Tennessee (3856) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1487262630

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameSAMANTHA DANIELLE LYON

Location Address1043 JACK VEST DRJohnson City, TN 37614-3761

Mailing AddressPo Box 699Mountain Home, TN 37684-0699

Phone(423) 439-4044

Sole ProprietorNo

Enumeration DateJuly 14, 2020

Last NPPES UpdateJanuary 18, 20242 updates tracked since enumeration

NPPES CertifiedJanuary 18, 2024

✔ NPI 1487262630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in TN · 3856

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1043 JACK VEST DR, Johnson City, TN 37614

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Secondary Practice Locations 2

Location 17714 Conner RdPowell, TN 37849-3559 · Phone (865) 947-6220 · Fax (865) 512-1069

Location 24 Sheridan Sq Ste 200Kingsport, TN 37660-7435 · Phone (423) 246-7931

Other Identifiers 1

MedicaidQ078517TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Danielle Lyon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Lyon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medical Education Assistance Corporation

3.1 mi

Internal Medicine

101 MED TECH PKWY STE 306
Johnson City, TN 37604

Reassigned Medicare billing, Tennessee enrollment
341 clinicians in this Medicare group

NPI 1235180480 (423) 433-6039

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$160.89 typical visit price

range $52.64 – $160.89

Typical copayment $40.22 (range $13.16 – $40.22)

Most-billed visit code 99205

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH COOK PT, DPT

Physical Therapist