Bethany Wiley Lill

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

006629 Issued in GA

Practice address

720 Transit Ave
Suite 202
Canton, GA 30114-2540

Phone

(770) 427-5717

Fax

(770) 514-6744

NPI assigned

Sep 22, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Orthopaedics and Sports Medicine Specialists LLCGroup PAC ID 6204723216, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bethany.lill@po.eclinicaldirectplus.com
• Direct secure messaging: bethany.lill.1@15749.direct.athenahealth.com

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.

• Pinnacle Orthopaedics & Sports Medicine Specialists LLC

  • Specialist
  • Marietta, GA
  • NPI 1194815175
  Medicare reassignment Care Compare group NPD (past)
• Pinnacle Orthopaedics & Sports Medicine Specialists LLC

  • Specialist
  • Marietta, GA
  • NPI 1003367707
  NPD

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

• Kennestone Hospital, Inc.

  dba Wellstar Kennestone Hospital

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Windy Hill Hospital

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Cherokee

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation

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

{
    "created_epoch": "1348272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1316298953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609404",
            "telephone_number": "770-427-5717",
            "fax_number": "770-514-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 TRANSIT AVE",
            "address_2": "SUITE 202",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142540",
            "telephone_number": "770-427-5717",
            "fax_number": "770-514-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILL",
        "first_name": "BETHANY",
        "middle_name": "WILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-22",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "006629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "20I2973206",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Rose Liebmann, BT
• Yee Ling Lieu
• Life of Food LLC
• Life Stat EMS
• Alyssa Liguori, D.O.
• Christina L Liming, MS, CCC-SLP
• Aisha Linge, PHARMD
• Ruximar Hernandez Linkous, DDS
• Michael J Litrel, M.D.
• Little River Family Chiropractic, Inc

• Surgical Physician Assistant in Canton, GA
• Providers in Canton, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.