Individual provider Active NPI

Lillian B Donnelly

  • Home Health Agency
  • Michigan Center, MI
National Provider Identifier
1518736362
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
4542 Page Ave
Michigan Center, MI 49254-1040
Phone
(517) 764-1202
Fax
(517) 782-0052
NPI assigned
Dec 21, 2023
Last updated
Dec 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X MI Primary
Registered Nurse 163W00000X 4704254121 MI

Addresses

Primary practice location

4542 Page Ave
Michigan Center, MI 49254-1040

Mailing address

4542 Page Ave
Michigan Center, MI 49254-1040
Phone (517) 764-1202

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704254121MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
D & D Family Care Home Health CurrentSince Jan 14, 2024 Accepting new patients

Locations

4542 Page Ave
Michigan Center, MI 49254
Phone (517) 764-1202

Organizations & group practices 1

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": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1518736362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4542 PAGE AVE",
            "city": "MICHIGAN CENTER",
            "state": "MI",
            "postal_code": "492541040",
            "telephone_number": "517-764-1202",
            "fax_number": "517-782-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4542 PAGE AVE",
            "city": "MICHIGAN CENTER",
            "state": "MI",
            "postal_code": "492541040",
            "telephone_number": "517-764-1202",
            "fax_number": "517-782-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "LILLIAN",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704254121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan Center, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.