Active NPI
Darla Lilleberg
- Specialist
- Charlotte, NC
National Provider Identifier
1568828994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 753135
- Practice address
- 428 E 4TH St
Suite 333
Charlotte, NC 28202-2434 - Phone
- (980) 819-1329
- NPI assigned
- Jan 14, 2016
- Last updated
- Jan 14, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 753135 | NC | Primary |
Addresses
Primary practice location
428 E 4TH St
Suite 333
Charlotte, NC 28202-2434
Mailing address
428 E 4TH St
Suite 333
Charlotte, NC 28202-2434
Phone (980) 819-1329
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
| License | State | Type | Specialty |
|---|---|---|---|
| 753135 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1568828994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "428 E 4TH ST",
"address_2": "SUITE 333",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282022434",
"telephone_number": "980-819-1329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 E 4TH ST",
"address_2": "SUITE 333",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282022434",
"telephone_number": "980-819-1329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLEBERG",
"first_name": "DARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-14",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "753135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.