MR. KENNETH RAY LYMAN FNP-BC
NPI 1841447174
Nurse Practitioner - Family in Rolla, MO

Q: What is Kenneth Lyman's NPI number?

The NPI number for Kenneth Lyman is 1841447174. It was assigned to this individual provider in the NPPES registry on August 18, 2008.

Q: What is Kenneth Lyman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Lyman was last updated on March 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 August 18, 2008PECOS Enrolled

1050 W. 10TH STREET, SUITE 300, ROLLA, MO 65401(573) 364-9000(573) 426-3552 Get Directions Write a Review

NPPES record last updated: March 27, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Mr. Kenneth Ray Lyman Fnp-bc NPPES

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

MR. KENNETH RAY LYMAN FNP-BC (NPI 1841447174) is an individual family provider in Rolla, Missouri, licensed in Missouri (2010033190) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841447174

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. KENNETH RAY LYMANCredential: FNP-BC

Location Address1050 W. 10TH STREET, SUITE 300Rolla, MO 65401

Mailing Address1050 W. 10th Street, Suite 300Rolla, MO 65401 · (573) 364-9000 · Fax (573) 426-3552

Phone(573) 364-9000

Fax(573) 426-3552

Sole ProprietorNo

Enumeration DateAugust 18, 2008

Last NPPES UpdateMarch 27, 2012

✔ NPI 1841447174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in MO · 2010033190✔ Licensed in WI · 3491-033

1050 W. 10TH STREET, Rolla, MO 65401

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kenneth Ray Lyman Fnp-bc 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 Kenneth Lyman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Public Hospital District No 1 Of Mason County

1,697 mi

Podiatric

2964B LIMITED LN NW
Olympia, WA 98502

Reassigned Medicare billing, Washington enrollment
154 clinicians in this Medicare group

NPI 1740642024 (360) 943-1400

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 65401 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Lyman's NPI number?

The NPI number for Kenneth Lyman is 1841447174. It was assigned to this individual provider in the NPPES registry on August 18, 2008.

Where is Kenneth Lyman located?

Kenneth Lyman practices at 1050 W. 10th Street Suite 300, Rolla, MO 65401. The listed phone number is (573) 364-9000.

What is Kenneth Lyman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kenneth Lyman enrolled in Medicare?

Yes. Kenneth Lyman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kenneth Lyman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Lyman reassigns Medicare benefits to Public Hospital District No 1 Of Mason County (Olympia, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Lyman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth Lyman was last updated on March 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.