Lighthouse Primary Care, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

LIGHTHOUSE PRIMARY CARE, LLC

Practice address

1288 S Governors Ave Ste B
Dover, DE 19904-4802

Phone

(302) 674-4545

Fax

(800) 507-3166

NPI assigned

Feb 12, 2024

Last updated

Aug 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra EgglestonNPI 1861983462

Title

DNP, Aprn, FNP-C

Phone

(302) 674-4545

Specialties & licenses 1

Addresses

Other names 1

• Lighthouse Primary Care, LLC Other name

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra Eggleston

  • Family Nurse Practitioner
  • Dover, DE
  • NPI 1861983462
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1023872827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199030515",
            "telephone_number": "302-674-4545",
            "fax_number": "800-507-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1288 S GOVERNORS AVE STE B",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044802",
            "telephone_number": "302-674-4545",
            "fax_number": "800-507-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "EGGLESTON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "DNP, APRN, FNP-C",
        "authorized_official_telephone_number": "302-674-4545"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Primary Care, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lighthouse Primary Care, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Lifestyle Counseling (YPH Consultants, LLC)
• Lighthouse Community Support
• Khusmanie Lila
• Francis Lim, MD
• Shannon S Lim, RPH
• Guirlande Moridon Lima
• Wai Wai Lin, MD

• Primary Care Nurse Practitioner in Dover, DE
• Providers in Dover, DE by specialty
• Primary Care Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.