Bert Lillard, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1951 Issued in OK

Practice address

521 Main St
Van Buren, AR 72956-5109

Phone

(479) 410-1740

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Stein Ancillary Services, LLC

  • Rehabilitation Practitioner
  • Fort Smith, AR
  • NPI 1073591582

  OK, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083817324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 N WITTE ST",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749535621",
            "telephone_number": "479-647-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MAIN ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565109",
            "telephone_number": "479-410-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLARD",
        "first_name": "BERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "1951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Leonard
• Terri J Lewelling, MD
• Madelyn Lewis
• Ronald A Lewis
• Myra Elizabeth Lightfoot
• Mary A Linn, PA-C
• Xana Lockhart
• Jessica Logsdon, LPN
• Jensen Long
• Maya Longino

• Physical Therapist in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Physical Therapist in Arkansas

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.