Individual provider Active NPI

Lyri L Merrill, PT

  • Orthopedic Physical Therapist
  • Swansea, IL
National Provider Identifier
1467562926
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
070-016066 Issued in IL
Practice address
4 Executive Woods CT
Suite C
Swansea, IL 62226-2016
Phone
(618) 444-2846
Fax
(618) 239-6444
NPI assigned
Aug 30, 2006
Last updated
Feb 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 112199 MO
Orthopedic Physical Therapist 2251X0800X 070-016066 IL Primary

Addresses

Primary practice location

4 Executive Woods CT
Suite C
Swansea, IL 62226-2016

Mailing address

4 Executive Woods CT
Suite C
Swansea, IL 62226-2016
Phone (618) 444-2846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-016066ILMDOrthopedic Physical Therapist
112199MOMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anam Healing Arts, LLC Past Accepting new patients
Ashley a Gaines DC, LLC Past Accepting new patients

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1467562926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 EXECUTIVE WOODS CT",
            "address_2": "SUITE C",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262016",
            "telephone_number": "618-444-2846",
            "fax_number": "618-239-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EXECUTIVE WOODS CT",
            "address_2": "SUITE C",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262016",
            "telephone_number": "618-444-2846",
            "fax_number": "618-239-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "LYRI",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "112199",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070-016066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.