Lily Revena Sumner-Burns, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

256412 Issued in KY

Practice address

1043 Center Dr
Richmond, KY 40475-3838

Phone

(859) 314-1281

Fax

(859) 353-8032

NPI assigned

Feb 18, 2022

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 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital, Inc.Group PAC ID 4486616141, shared by 9 NPIs, 60 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Memorial Hospital Inc.

  • Rural Health Clinic/Center
  • Manchester, KY
  • NPI 1255471827
  Medicare reassignment NPD
• Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Beverly, KY
  • NPI 1558665752
  Medicare reassignment NPD
• Memorial Hospital, Inc.

  • Specialist
  • Manchester, KY
  • NPI 1831150119

  Clinical

  Medicare reassignment NPD
• Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Oneida, KY
  • NPI 1881112134
  Medicare reassignment NPD
• Kentucky River Community Care, Inc

  • Mental Health Counselor
  • Hazard, KY
  • NPI 1528017142

  Clinical

  NPD
• Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • McKee, KY
  • NPI 1023649514
  NPD

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1487309449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 CENTER DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753838",
            "telephone_number": "859-314-1281",
            "fax_number": "859-353-8032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3476 Hwy 80 W",
            "address_purpose": "LOCATION",
            "city": "Emmalena",
            "state": "KY",
            "postal_code": "417408854",
            "country_code": "US",
            "telephone_number": "606-436-5761 x7220",
            "fax_number": "606-436-5797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Rockwood Ln",
            "address_purpose": "LOCATION",
            "city": "Hazard",
            "state": "KY",
            "postal_code": "417019415",
            "country_code": "US",
            "telephone_number": "606-436-5761 x7220",
            "fax_number": "606-436-5797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMNER-BURNS",
        "first_name": "LILY",
        "middle_name": "REVENA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100798520",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Hazard",
            "affiliation": "N",
            "address_1": "115 Rockwood Ln",
            "city": "Hazard",
            "state": "KY",
            "country_code": "US",
            "postal_code": "417019415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Richmond",
            "affiliation": "Y",
            "affiliationName": "Lexington Counseling and Psychiatry, PLLC",
            "address_1": "1043 Center Dr",
            "city": "Richmond",
            "state": "KY",
            "country_code": "US",
            "postal_code": "404753838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Amber Sundby
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• Mehul Ajay Suthar, D.O.
• Sandra L. Swayze, M.D.

• Clinical Social Worker in Richmond, KY
• Providers in Richmond, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.