Lilly Eye Care, Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

WV17041 Issued in WV

Legal business name

LILLY EYE CARE, INC.

Practice address

2823 3Rd Ave
Huntington, WV 25702-1423

Phone

(304) 523-3937

Fax

(304) 523-3945

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dale Blake Lilly, MDNPI 1376557918

Title

President

Phone

(304) 523-3937

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dale Blake Lilly, M.D.

  • Ophthalmology Physician
  • Huntington, WV
  • NPI 1376557918
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053495820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021423",
            "telephone_number": "304-523-3937",
            "fax_number": "304-523-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021423",
            "telephone_number": "304-523-3937",
            "fax_number": "304-523-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILLY EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-523-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WV",
            "license": "WV17041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdeline Liddon, PRSS
• Life Encouragement Outreach
• Reagan Sidney Light
• Jennifer Dawn Lightle
• Chase M Liles
• Brandon Lilly
• Cory Lilly, PR
• Dale Blake Lilly, M.D.
• Dani Lilly
• Julia Lilly

• Medical Specialty Clinic/Center in Huntington, WV
• Providers in Huntington, WV by specialty
• Medical Specialty Clinic/Center in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.