Individual provider Active NPI

Lilla WD Gilbert, CNP

  • Gerontology Nurse Practitioner
  • Las Cruces, NM
National Provider Identifier
1518088640
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
78977 Issued in NM
Practice address
175 Roadrunner Pkwy
Las Cruces, NM 88011-5235
Phone
(505) 413-3719
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP-05114 OH
Gerontology Nurse Practitioner 363LG0600X 78977 NM Primary

Addresses

Primary practice location

175 Roadrunner Pkwy
Las Cruces, NM 88011-5235

Mailing address

7683 SE 27TH St #351
Mercer Island, WA 98040
Phone (505) 413-3719

Other identifiers 1

IdentifierTypeStateIssuer
2182249MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240609000205 NM Practitioner - Nurse Practitioner 2860531050 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-05114OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cura Healthcare CurrentSince May 15, 2024 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients

Locations

8226 Menaul Blvd NE
Albuquerque, NM 87110
Phone (505) 413-3719

7683 SE 27th St
Mercer Island, WA 98040
Phone (206) 228-8530

Interoperability endpoints

  • Direct secure messaging: lgilbert4804@direct.ccf.org

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1518088640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7683 SE 27TH ST #351",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "98040",
            "telephone_number": "505-413-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ROADRUNNER PKWY",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115235",
            "telephone_number": "505-413-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "LILLA",
        "middle_name": "WD",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "NP-05114",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "78977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2182249",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.