Peggy Yvonne Lively, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3938 Issued in SC

Practice address

1120 Glenns Bay Rd
Surfside Beach, SC 29575-4757

Phone

(843) 215-5492

NPI assigned

Mar 29, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14811/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/1897/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1033239678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 SHELL CT",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295754630",
            "telephone_number": "954-895-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 GLENNS BAY RD",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295754757",
            "telephone_number": "843-215-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "PEGGY",
        "middle_name": "YVONNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1563",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Surfside Beach, SC
• Providers in Surfside Beach, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.