Individual provider Active NPI

Patrick Bryan Lilly, DO

  • General Practice Physician
  • Vincennes, IN
National Provider Identifier
1245225689
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
02001209A Issued in IN
Practice address
520 S 7TH St
Vincennes, IN 47591-1038
Phone
(812) 885-3685
Fax
(812) 885-3917
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 02001209A IN Primary

Addresses

Primary practice location

520 S 7TH St
Vincennes, IN 47591-1038

Mailing address

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Memorial Medical Center Inc CurrentSince Jul 20, 1993 Accepting new patients
Deaconess Memorial Medical Center Inc Current Accepting new patients
Deaconess Memorial Medical Center Inc CurrentSince Jul 20, 1993 Accepting new patients

Locations

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

600 W 13th St
Ste 100
Jasper, IN 47546
Phone (812) 996-2345

Interoperability endpoints

  • Direct secure messaging: plilly21689@direct.mhhcc.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245225689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-885-3685",
            "fax_number": "812-885-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-885-3685",
            "fax_number": "812-885-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "PATRICK",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02001209A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.