Active NPI
Lily Megan Whiteside, PA-C
- Physician Assistant
- Kettering, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.009369RX
- Practice address
- 3700 Southern Blvd Ste 300
Kettering, OH 45429-1265 - Phone
- (937) 643-9299
- NPI assigned
- Aug 12, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14239 | MN | |
| Physician Assistant | 363A00000X | 50.009369RX | OH | Primary |
Addresses
Primary practice location
3700 Southern Blvd Ste 300
Kettering, OH 45429-1265
Mailing address
1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310
Other practice location 1
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 273-8383
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ | ||
| Direct Messaging Address | lwhiteside751612@direct.ketteringhealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646
4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309
4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751
Hospital & facility affiliations
- Kettering Health Main Campus
- Kettering Health Dayton
- Soin Medical Center
- Fort Hamilton Hughes Memorial Hospital
- Kettering Health Troy
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.63 of 100
- Quality
- 75.41
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.75
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.66 of 100
- Quality
- 79.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14239 | MN | MD | Physician Assistant |
| 50.009369RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
Organizations & group practices 11
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Emergency Medicine Physician
- Minneapolis, MN
- NPI 1811077175
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- Multi-Specialty Clinic/Center
- Andover, MN
- NPI 1477734705
-
- Clinic/Center
- Edina, MN
- NPI 1164013348
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
-
- Land Ambulance
- Saint Paul, MN
- NPI 1710212485
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
- General Acute Care Hospital
- Troy, OH
- NPI 1023587045
-
- General Acute Care Hospital
- Kettering, OH
- NPI 1043233984
-
- General Acute Care Hospital
- Hamilton, OH
- NPI 1104867167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759363200000",
"number": "1558099929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PRESTIGE PL STE 550",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453426115",
"telephone_number": "937-762-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 SOUTHERN BLVD STE 300",
"city": "KETTERING",
"state": "OH",
"postal_code": "454291265",
"telephone_number": "937-643-9299"
}
],
"practiceLocations": [
{
"address_1": "909 Fulton St SE",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554554800",
"country_code": "US",
"telephone_number": "612-273-8383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITESIDE",
"first_name": "LILY",
"middle_name": "MEGAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-12",
"last_updated": "2025-10-02",
"certification_date": "2025-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "14239",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.009369RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
"affiliation": "N",
"address_1": "3700 Southern Blvd Ste 300",
"city": "Kettering",
"state": "OH",
"country_code": "US",
"postal_code": "454291265",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lwhiteside751612@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "3700 Southern Blvd Ste 300",
"city": "Kettering",
"state": "OH",
"country_code": "US",
"postal_code": "454291265",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.