William Lytollis, PHD, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

057392 Issued in GA

Practice address

200 Stahlhut Dr
Lincoln, IL 62656-5066

Phone

(217) 528-7541

NPI assigned

May 1, 2006

Last updated

Dec 11, 2020By 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

Medicare fee-for-service enrollment

Enrolled in GA, DE, WI3 enrollments

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.

Enrollment records 3

Specialty

Nephrology

Education

Oregon Health Sciences University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Physician Services - Southeast Professional CorporationGroup PAC ID 5597774554, 825 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: williamlytollis@sfc.allscriptsdirect.net

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.

• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group, Delaware, Inc

  • Internal Medicine Physician
  • Dover, DE
  • NPI 1326485285
  Medicare reassignment NPD
• Apogee Medical Group, Wisconsin, S.C

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1629415591

  WI

  Medicare reassignment NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Memorial Medical Center

  dba The Hearing Center at Memorial

  • Audiologist
  • Springfield, IL
  • NPI 1679549968
  NPD (past)
• Apogee Medical Group Georgia Inc

  • Internal Medicine Physician
  • Carrollton, GA
  • NPI 1629025143
  NPD (past)
• Piedmont Walton Hospital Inc

  • General Acute Care Hospital
  • Monroe, GA
  • NPI 1720589328
  NPD (past)
• Providence Health & Services - Oregon

  dba Prov St. Vincent Medical Ctr

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745
  NPD (past)

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

• Piedmont Walton Hospital Inc

  • General Acute Care Hospital
  • Monroe, GA
  • NPI 1720589328
  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1386602407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STAHLHUT DR",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626565066",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYTOLLIS",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "057392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "036144534",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "057392",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincoln Village Healthcare Center LLC
• Logan County Paramedic Association, Inc
• Cynthia Ann Lohr, COTA/L
• Kevin S Londe, DO
• Lynn M Dennis Dennis Foot and Ankle Center
• Roberta Mangano, MS. MSW. LPC
• Maple Ridge Care Centre LLC
• Cynthia Marcotte
• Mark Canty MD, LTD
• Rachel Victoria McCray

• Nephrology Physician in Lincoln, IL
• Providers in Lincoln, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.