Raymond Lilly Jr., M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

31336 Issued in CO

Practice address

1600 N Grand Ave
Ste 508
Pueblo, CO 81003-2757

Phone

(719) 595-7040

Fax

(719) 595-7045

NPI assigned

Jul 7, 2005

Reactivated

Mar 27, 2006

Last updated

Oct 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• R. Lindsay Lilly, Jr Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1376541094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "STE 508",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032757",
            "telephone_number": "719-595-7040",
            "fax_number": "719-595-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N GRAND AVE",
            "address_2": "STE 508",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032757",
            "telephone_number": "719-595-7040",
            "fax_number": "719-595-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "RAYMOND",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2012-10-12",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "31336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00149591",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01313360",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "LILLY, JR",
            "middle_name": "LINDSAY",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rickland Lawrence Likes, D.O.
• Shauna Likes, MPT
• Louis Lile
• Patrick Liles, OD
• Lillian Krow-Jones, LCSW
• Stona B Lilly, RNFA
• Vicki Lim, LMT
• Limelight Assisted Living - Pueblo LLC (Limelight at East Side Assisted Living)
• Limelight Assisted Living - Pueblo LLC (Limelight at Citadel Assisted Living)
• Stephanie Louise Linan, LPN

• Neurological Surgery Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Neurological Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.