Individual provider Active NPI

Lillian Machelle Loretz, DPM

  • Podiatrist
  • Savannah, GA
National Provider Identifier
1356376743
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD000860 Issued in GA
Practice address
6709 Waters Ave
Savannah, GA 31406-2717
Phone
(912) 777-3164
Fax
(912) 777-3165
NPI assigned
Jul 12, 2006
Last updated
Mar 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD000860 GA Primary

Addresses

Primary practice location

6709 Waters Ave
Savannah, GA 31406-2717

Mailing address

6709 Waters Waters Ave
Savannah, GA 31406-2717
Phone (912) 777-3164

Other identifiers 1

IdentifierTypeStateIssuer
000817242CMedicaidGA

Other names 1

  • Dr. Lillian Machelle Loretz Former name

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040526001536 GA Practitioner - Podiatry 6305827221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curtis V. Cooper Primary Health Care, Inc.Group PAC ID 4789667015, shared by 13 NPIs, 32 clinicians

Practice addresses (Care Compare)

106 E Broad St
Savannah, GA 31401-2917
Phone (912) 527-1000

6709 Waters Ave
Savannah, GA 31406-2717
Phone (912) 777-3164

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue281
Removal or shaving of skin growth87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD000860GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Williams Foot and Leg Specialty Care Inc CurrentSince Dec 21, 2013 Accepting new patients
Antioch Vascular Center, LLC Past Accepting new patients
Carl J Cooper MD PC Past Accepting new patients
Antioch Medical Associates Podiatrist PastSince Feb 17, 2018 Accepting new patients
Podiatric Medical Associates Podiatrist Past Accepting new patients

Locations

6709 Waters Ave
Savannah, GA 31406
Phone (912) 777-3164

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1356376743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 WATERS WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062717",
            "telephone_number": "912-777-3164",
            "fax_number": "912-777-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6709 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062717",
            "telephone_number": "912-777-3164",
            "fax_number": "912-777-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORETZ",
        "first_name": "LILLIAN",
        "middle_name": "MACHELLE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000817242C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILLIAN",
            "last_name": "LORETZ",
            "middle_name": "MACHELLE",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.