Active NPI
Loren Edgar Lilly, RRT
- Pulmonary Rehabilitation Registered Respiratory Therapist
- Mesa, AZ
National Provider Identifier
1104952043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Rehabilitation Registered Respiratory Therapist
- License
- 1759
- Practice address
- 6343 East Main Street
Suite 8
Mesa, AZ 85205 - Phone
- (480) 325-8838
- NPI assigned
- Feb 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Rehabilitation Registered Respiratory Therapist | 2279P1005X | 1759 | AZ | Primary |
Addresses
Primary practice location
6343 East Main Street
Suite 8
Mesa, AZ 85205
Mailing address
4119 East Juanita Ave.
Higley, AZ 85236
Phone (480) 292-1328
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104952043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4119 EAST JUANITA AVE.",
"city": "HIGLEY",
"state": "AZ",
"postal_code": "85236",
"telephone_number": "480-292-1328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6343 EAST MAIN STREET",
"address_2": "SUITE 8",
"city": "MESA",
"state": "AZ",
"postal_code": "85205",
"telephone_number": "480-325-8838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "LOREN",
"middle_name": "EDGAR",
"name_prefix": "Mr.",
"credential": "RRT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2279P1005X",
"taxonomy_group": "",
"desc": "Respiratory Therapist, Registered, Pulmonary Rehabilitation",
"state": "AZ",
"license": "1759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
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- Lighthouse Support Services LLC
- Lighthouse Support Services LLC
- Daisy Hannah Liljenquist, PA
- Christine Lillywhite, M.S., MT-BC
- Alice Lim, DDS
- Kellie Marie Lim, PA-C
- Ruth T. Lim, M.D.
- Tracy Thao Thach Lin, PHARMD
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.