Lilly Balsamo Gant, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1207033 Issued in TX

Practice address

2106 Rabb Glen St
Austin, TX 78704-3946

Phone

(512) 580-9204

NPI assigned

Jul 18, 2025

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Modern Pediatrics Professionals, PLLC

  • Pediatrics Physician
  • Austin, TX
  • NPI 1154952505
  NPD (past)

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1518859065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 SONG SPARROW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787444711",
            "telephone_number": "214-236-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 RABB GLEN ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787043946",
            "telephone_number": "512-580-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANT",
        "first_name": "LILLY",
        "middle_name": "BALSAMO",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1207033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Gannon, PT, DPT
• Caitlin Eileen Gannon, PH.D.
• Kathleen Gannon, MAOM, DAOM
• Jason Blaise Gans
• Sarah M. Ganske, AU.D.
• Neelima Nagabattula Ganta, M.D.
• Sashidhar V. Ganta, M.D.
• Bhaskara Michael Ganti, MD
• Shawnetta Gantt-Wilkins, LPC-S, LCDC, ASOTP,
• Brandi Ganz

• Pediatric Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; 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.