Individual provider Active NPI

Lilas Dorothy Harley, DO

  • Student in an Organized Health Care Education/Training Program
  • Bradenton, FL
National Provider Identifier
1508489550
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2020 26TH Ave E
Bradenton, FL 34208-7753
Phone
(941) 782-4600
Fax
(941) 782-4601
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2020 26TH Ave E
Bradenton, FL 34208-7753

Mailing address

PO Box 197515
Nashville, TN 37219-7515
Phone (941) 782-4391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240904000679 FL Practitioner - Psychiatry 7911447008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerstone of Florida IncGroup PAC ID 2668468596, 35 clinicians

Practice addresses (Care Compare)

379 6TH Ave W
Bradenton, FL 34205-8820
Phone (941) 782-4150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Florida, Inc. CurrentSince Jul 27, 2024 Accepting new patients
Centerstone of Florida, Inc. CurrentSince Jul 4, 2021 Accepting new patients

Locations

379 6th Ave W
Bradenton, FL 34205
Phone (941) 782-4100

2020 26th Ave E
Bradenton, FL 34208
Phone (941) 782-4600

4010 Sawyer Rd
Sarasota, FL 34233
Phone (941) 924-9892

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1508489550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197515",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372197515",
            "telephone_number": "941-782-4391",
            "fax_number": "941-782-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 26TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342087753",
            "telephone_number": "941-782-4600",
            "fax_number": "941-782-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "LILAS",
        "middle_name": "DOROTHY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.