Individual provider Active NPI

Lily Campbell

  • Nurse Practitioner
  • Harrisville, WV
National Provider Identifier
1194607713
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
109136 Issued in WV
Practice address
135 S Penn Ave
Harrisville, WV 26362-1371
Phone
(304) 643-4007
NPI assigned
Jul 24, 2025
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 109136 WV Primary

Addresses

Primary practice location

135 S Penn Ave
Harrisville, WV 26362-1371

Mailing address

135 S Penn Ave
Harrisville, WV 26362-1371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251124001610 WV Practitioner - Nurse Practitioner 2163914581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

135 S Penn Ave
Harrisville, WV 26362-1371
Phone (304) 643-4005

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
109136WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ritchie County Primary Care Assoc., Inc. Current Accepting new patients
Ritchie County Primary Care Assoc., Inc. CurrentSince Sep 7, 2025 Accepting new patients
Ritchie County Primary Care Assoc., Inc. CurrentSince Sep 7, 2025 Accepting new patients

Locations

135 S Penn Ave
Harrisville, WV 26362
Phone (304) 343-4005

1200 Stephenson Ave
Parkersburg, WV 26101
Phone (304) 420-5819

1513 Blizzard Dr
Parkersburg, WV 26101
Phone (304) 699-0809

2330 N Pleasants Hwy
Saint Marys, WV 26170
Phone (855) 552-8907

151 Doddridge County School Rd
West Union, WV 26456
Phone (304) 873-0060

79 Bulldog Dr
West Union, WV 26456

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1194607713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S PENN AVE",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263621371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S PENN AVE",
            "city": "HARRISVILLE",
            "state": "WV",
            "postal_code": "263621371",
            "telephone_number": "304-643-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "109136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisville, WV

Sources for this page

Verify at the official NPI Registry.