Active NPI
Lily E Formby, RD
- Registered Dietitian
- Little Rock, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2092
- Practice address
- 8924 Kanis Rd
Little Rock, AR 72205-6414 - Phone
- (501) 455-2712
- Fax
- (501) 455-2781
- NPI assigned
- Jul 20, 2021
- Last updated
- Jul 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2092 | AR | Primary |
Addresses
Primary practice location
8924 Kanis Rd
Little Rock, AR 72205-6414
Mailing address
PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2092 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arcare | Current | Accepting new patients | |
| Baptist Health Hospitals | Current | Accepting new patients | |
| Arcare | Current | Accepting new patients | |
| Baptist Health Hospitals | Current | Accepting new patients |
Locations
623 N 9th St
#40
Augusta, AR 72006
8924 Kanis Rd
Little Rock, AR 72205
Phone (501) 227-4750
1703 N Buerkle St
Stuttgart, AR 72160
Phone (870) 674-6301
Organizations & group practices 4
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.
-
dba BHH Physician Clinic
- Nutrition Education Nutritionist
- Stuttgart, AR
- NPI 1982016028
-
- Federally Qualified Health Center (FQHC)
- Augusta, AR
- NPI 1275635542
-
dba Baptist Medical Center Stuttgart
- Critical Access Hospital
- Stuttgart, AR
- NPI 1790773158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627257600000",
"number": "1508439480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 497",
"city": "AUGUSTA",
"state": "AR",
"postal_code": "720060497",
"telephone_number": "870-347-2534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8924 KANIS RD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722056414",
"telephone_number": "501-455-2712",
"fax_number": "501-455-2781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMBY",
"first_name": "LILY",
"middle_name": "E",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2021-07-26",
"certification_date": "2021-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AR",
"license": "2092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.