Active NPI
Patrick Bryan Lilly, DO
- General Practice Physician
- Vincennes, IN
National Provider Identifier
1245225689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 02001209A
- 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
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 |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deaconess Memorial Medical Center Inc | Current | Accepting new patients | |
| Deaconess Memorial Medical Center Inc | Current | Accepting new patients | |
| Deaconess Memorial Medical Center Inc | Current | 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
- 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.
-
dba Memorial Healthcare of Huntingburg
- Emergency Medicine Physician
- Huntingburg, IN
- NPI 1114120128
-
dba Deaconess Comprehensive Pain Management - Jasper
- Pain Medicine Physician
- Jasper, IN
- NPI 1457164543
-
dba Memorial Hospital and HealthCare Center
- Hospitalist Physician
- Jasper, IN
- NPI 1588778518
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
- 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; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.