Lillie Grantham, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19201 Issued in TX

Practice address

4945 Williams Dr
Georgetown, TX 78633-2008

Phone

(512) 819-0500

NPI assigned

Mar 17, 2025

Last updated

Dec 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
• Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128
• Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Lakeway, TX, CCN 673058

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgrantham1440757@direct.sw.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Scott & White Clinic

  dba Baylor Scott & White Clinic - Temple

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment Care Compare group
• Scott & White Clinic

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1649820796
  NPD
• Scott & White Clinic

  • Internal Medicine Physician
  • Pflugerville, TX
  • NPI 1679691729
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Scott & White Medical Centers - Capitol Area

  dba Baylor Scott & White Medical Center - Pflugerville

  • General Acute Care Hospital
  • Pflugerville, TX
  • NPI 1346729159
  Care Compare affiliation
• Bir JV LLP

  dba Baylor Scott & White Institute for Rehabilitation - Lakeway

  • Rehabilitation Hospital
  • Lakeway, TX
  • NPI 1851889463

  Inpatient rehabilitation facility

  Care Compare affiliation
• Scott & White Hospital - Round Rock

  dba Baylor Scott & White Medical Center - Round Rock

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1265568638
  Care Compare affiliation

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1023818143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371",
            "fax_number": "254-215-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4945 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332008",
            "telephone_number": "512-819-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "LILLIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgrantham1440757@direct.sw.org",
            "affiliation": "N",
            "address_1": "4945 Williams Dr",
            "city": "Georgetown",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786332008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Grace M Salone, OD, PLLC (Texas State Optical)
• Grace Psychiatric Services, PLLC
• Rosa Lopez Gragan
• Austin Thomas Graham, OPA-C
• Dalton Graham
• Susan Leslie Granville, PA
• Great Hills Eye Care, PC
• Gabrielle Lynn Green
• Jalyn Green
• Kenneth Walter Green, LMT, OM

• Physician Assistant in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.