Individual provider Active NPI

Lynette Y. Zills, M.D.

  • Family Medicine Physician
  • Springfield, IL
National Provider Identifier
1114028107
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.35499 Issued in AL
Practice address
1025 S 6TH St
Springfield, IL 62703-2403
Phone
(217) 528-7541
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-086942 IL
Family Medicine Physician 207Q00000X MD.35499 AL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2403

Mailing address

7191 Cahaba Valley Rd
Birmingham, AL 35242-6443
Phone (205) 408-2365

Other identifiers 1

IdentifierTypeStateIssuer
036086942MedicaidIL

Other names 1

  • Lynette Y. McBride Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115001464 AL Practitioner - Family Practice 5092735522 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.35499ALMDFamily Medicine Physician
036-086942ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent'S Urgent Care LLC CurrentSince Nov 1, 2018 Accepting new patients
Vincentian Physician Services LLC Family Medicine CurrentSince Oct 10, 2016 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

1944 28th Ave S
Homewood, AL 35209
Phone (205) 408-2366

7191 Cahaba Valley Rd
Hoover, AL 35242
Phone (205) 408-6555

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1114028107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7191 CAHABA VALLEY RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352426443",
            "telephone_number": "205-408-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZILLS",
        "first_name": "LYNETTE",
        "middle_name": "Y.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-086942",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.35499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086942",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNETTE",
            "last_name": "MCBRIDE",
            "middle_name": "Y.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.