Lily Herbert, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

17428 Issued in MS

Practice address

7680 Airways Blvd
Southaven, MS 38671-5304

Phone

(662) 349-1999

Fax

(662) 349-9734

NPI assigned

Sep 13, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lherbert206437@directinfirmaryhealth.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.

• Imc-Diagnostic and Medical Clinic LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1447201066
  Medicare reassignment NPD
• Imc-Diagnostic and Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • Saraland, AL
  • NPI 1568235000
  NPD
• Memphis Pathology Laboratory

  dba American Esoteric Laboratories

  • Clinical Medical Laboratory
  • Memphis, TN
  • NPI 1548370745
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083719199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7680 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715304",
            "telephone_number": "662-349-1999",
            "fax_number": "662-349-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7680 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715304",
            "telephone_number": "662-349-1999",
            "fax_number": "662-349-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "17428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7325405",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5307452003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lee Henderson, P-LPC
• Julia Mae Henderson, MA, LPC, BC-TMH
• Shoquana Henderson, BSW, RPSGT
• Todd Marcos Henderson, MD
• Terri Hayes Henson, MD
• Here and There Transportation, LLC
• Perry Hershfelt, AU.D.
• Nancyanne Page Hickman, P.T.
• Ashley Hicks, SLP
• Gloria S. Hicks, CRNA

• Internal Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.