Individual provider Active NPI

Maximillian Lilly, BSN

  • Student in an Organized Health Care Education/Training Program
  • Bethesda, MD
National Provider Identifier
1083550115
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
201341402RN Issued in OR
Practice address
4301 Jones Bridge Rd
Bethesda, MD 20814-4799
Phone
(301) 295-9004
NPI assigned
Apr 29, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 201341402RN OR Primary

Addresses

Primary practice location

4301 Jones Bridge Rd
Bethesda, MD 20814-4799

Mailing address

4301 Jones Bridge Rd
Bethesda, MD 20814-4799
Phone (301) 295-9004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
201341402RNORMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1083550115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144799",
            "telephone_number": "301-295-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 JONES BRIDGE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144799",
            "telephone_number": "301-295-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "MAXIMILLIAN",
        "credential": "BSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "201341402RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.