Active NPI
Frederick P Lillis, MD
- Internal Medicine Physician
- Leesburg, VA
National Provider Identifier
1669408126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101022634
- Practice address
- 224D Cornwall St NW
Suite 302
Leesburg, VA 20176-2700 - Phone
- (703) 737-7622
- Fax
- (703) 737-7943
- NPI assigned
- Jun 24, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101022634 | VA | Primary |
Addresses
Primary practice location
224D Cornwall St NW
Suite 302
Leesburg, VA 20176-2700
Mailing address
224D Cornwall St NW
Suite 302
Leesburg, VA 20176-2700
Phone (703) 737-7622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061845 | Other | VA | ANTHEM BLUE CROSS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101022634 | VA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1669408126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224D CORNWALL ST NW",
"address_2": "SUITE 302",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201762700",
"telephone_number": "703-737-7622",
"fax_number": "703-737-7943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224D CORNWALL ST NW",
"address_2": "SUITE 302",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201762700",
"telephone_number": "703-737-7622",
"fax_number": "703-737-7943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLIS",
"first_name": "FREDERICK",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-24",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101022634",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "061845",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.