John Wayne Lilly Jr., APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

64742 Issued in WV

Practice address

330 N. Eisenhower Dr.
Beckley, WV 25801-3140

Phone

(304) 929-0786

Fax

(304) 929-2278

NPI assigned

Jan 3, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. John Wayne Lilly Other name

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1346510716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014141",
            "telephone_number": "304-929-0786",
            "fax_number": "304-929-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N. EISENHOWER DR.",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013140",
            "telephone_number": "304-929-0786",
            "fax_number": "304-929-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "JOHN",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-03",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "64742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "LILLY",
            "middle_name": "WAYNE",
            "prefix": "MR.",
            "credential": "APRN, FNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brittany Lilly
• Debra Lynn Lilly, PH.D
• Iliasue Annmarie Lilly
• Jacob Ross Lilly, PHARMD
• Jennifer Lilly
• Katrina Lilly
• Landon Lilly, MA
• Leslie Leann Lilly, FNP-BC
• Lillith Lilly
• Melinda Lilly

• Family Nurse Practitioner in Beckley, WV
• Providers in Beckley, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.