Individual provider Active NPI

Shantel Lilley, LPN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1609546258
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
339546-01 Issued in NY
Practice address
60 Masseth St
Rochester, NY 14606-1147
Phone
(585) 504-9152
NPI assigned
Sep 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 339546-01 NY Primary

Addresses

Primary practice location

60 Masseth St
Rochester, NY 14606-1147

Mailing address

60 Masseth St
Rochester, NY 14606-1147

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
339546-01NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1609546258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MASSETH ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146061147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MASSETH ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146061147",
            "telephone_number": "585-504-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "SHANTEL",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "339546-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.