Nancy Laura Liles, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

0102036988 Issued in VA

Practice address

7455 McConnell Rd
Roanoke, VA 24019-3241

Phone

(540) 366-6729

Fax

(540) 265-7083

NPI assigned

May 17, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 10, 2013 through Jun 10, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Valley Integrative Medicine

  • Internal Medicine Physician
  • Roanoke, VA
  • NPI 1275924318
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376750646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7455 MCCONNELL RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240193241",
            "telephone_number": "540-366-6729",
            "fax_number": "540-265-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 MCCONNELL RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240193241",
            "telephone_number": "540-366-6729",
            "fax_number": "540-265-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "NANCY",
        "middle_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "VA",
            "license": "0102036988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "286206",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Light, AU.D.
• James Light, MD
• Sariah E Light, D.D.S.
• Like Family Healthcare LLC
• Jacob Anthony Likus, OD
• Chelsea Ann Liller, MS, OTR/L
• Paige Elizabeth Lilley
• Stacey Custer Lilley, L.P.C.
• Nicole Yvette Lilly, LPC
• Sherri Jo Lilly, PA

• Neuromusculoskeletal Medicine & OMM Physician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Virginia

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.