Breanna Nicole Lilly, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

AC004114 Issued in MD

Practice address

99 Tavern Rd
Martinsburg, WV 25401-2890

Phone

(304) 263-4999

Fax

(304) 263-0984

NPI assigned

Feb 2, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City Hospital IncGroup PAC ID 3375444524, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: bjahn33477@direct.wvuhsdirect.com

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.

• City Hospital Inc

  • Anesthesiology Physician
  • Martinsburg, WV
  • NPI 1942503164
  Medicare reassignment Care Compare group NPD
• Jefferson Memorial Hospital

  • Critical Access Hospital
  • Ranson, WV
  • NPI 1891722377
  Medicare reassignment NPD
• City Hospital, Inc.

  • Internal Medicine Physician
  • Ranson, WV
  • NPI 1336657493
  NPD
• Jefferson Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ranson, WV
  • NPI 1104242569
  NPD
• Jefferson Memorial Hospital

  • Internal Medicine Physician
  • Ranson, WV
  • NPI 1316364953
  NPD
• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Martinsburg, WV
  • NPI 1083617823
  NPD
• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Martinsburg, WV
  • NPI 1235853144
  NPD
• City Hospital Inc

  • Obstetrics & Gynecology Physician
  • Martinsburg, WV
  • NPI 1669261467
  NPD (past)
• City Hospital, Inc

  • General Acute Care Hospital
  • Martinsburg, WV
  • NPI 1457389249
  NPD (past)
• Jefferson Memorial Hospital

  • Anesthesiology Physician
  • Ranson, WV
  • NPI 1982704961
  NPD (past)
• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Berkeley Springs, WV
  • NPI 1568186153
  NPD (past)
• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Winchester, VA
  • NPI 1023217452
  NPD (past)

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1659024347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26005 RIDGE RD STE 200",
            "city": "DAMASCUS",
            "state": "MD",
            "postal_code": "208721899",
            "telephone_number": "301-414-2300",
            "fax_number": "301-414-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012890",
            "telephone_number": "304-263-4999",
            "fax_number": "304-263-0984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26005 Ridge Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Damascus",
            "state": "MD",
            "postal_code": "208721899",
            "country_code": "US",
            "telephone_number": "301-414-2300",
            "fax_number": "301-414-0476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "BREANNA",
        "middle_name": "NICOLE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MD",
            "license": "AC004114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BOARD OF NURSING",
            "identifier": "93424",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tasha Lorraine Lewis, BCBA, LBA
• Kelly Fangzhou Li, PHARM.D.
• Jason Liao
• Liftline Medical Transport, LLC
• Colleen Marie Liles, RD
• Susanne Caroline Lilly
• Thomas Scott Lilly, D.D.S.
• Shawn Michael Lindgren
• Quada Lindsay
• Robin Lindsey

• Advanced Practice Midwife in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Advanced Practice Midwife in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.

Verify at the official NPI Registry.