Charles J Lilly MD PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301048544 Issued in MI

Legal business name

CHARLES J LILLY MD PC

Practice address

2890 Health Parkway
Mount Pleasant, MI 48858

Phone

(989) 772-3886

Fax

(989) 773-6267

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Charles J Lilly, MDNPI 1043311848

Title

Doctor

Phone

(989) 772-3886

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles J Lilly, M.D.

  • Orthopaedic Surgery Physician
  • Mt Pleasant, MI
  • NPI 1043311848
  Medicare reassignment NPD Authorized official
• Carrie Ann White, PA

  • Physician Assistant
  • Mt Pleasant, MI
  • NPI 1235415860
  Medicare reassignment

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1619167996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 HEALTH PARKWAY",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-772-3886",
            "fax_number": "989-773-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 HEALTH PARKWAY",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-772-3886",
            "fax_number": "989-773-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J LILLY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "989-772-3886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301048544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0370822",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1644906",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Chaney
• Amanda J Chapman
• Madison Chapman, PHD LP
• McKenzie Chapman
• Chapters Counseling, LLC
• Heidi Danielle Chartier, MSW
• Stephen G. Chase, M.D.
• Hsin-Kai Chen, PA-C
• Neeta Chesla, DDS
• Alicia Chiasson

• Orthopaedic Surgery Physician in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.