Individual provider Active NPI

Rhonda J Lilley, PH.D.

  • Psychologist
  • Columbus, OH
National Provider Identifier
1669598017
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4480 Issued in OH
Practice address
1550 Old Henderson Rd Ste E212
Columbus, OH 43220-3652
Phone
(614) 947-0936
Fax
(614) 947-0937
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4480 OH Primary

Addresses

Primary practice location

1550 Old Henderson Rd Ste E212
Columbus, OH 43220-3652

Mailing address

8963 Macintyre Dr
Dublin, OH 43017-8543
Phone (614) 764-9791

Other identifiers 1

IdentifierTypeStateIssuer
0867709MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20070719000389 OH Practitioner - Clinical Psychologist 1850492968 Practice locations: Columbus, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1550 Old Henderson Rd
Suite E212
Columbus, OH 43220-3652
Phone (614) 947-0936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4480OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Stoneburner & Associates LLC Past Accepting new patients
Universal Medical Administration Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669598017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8963 MACINTYRE DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430178543",
            "telephone_number": "614-764-9791",
            "fax_number": "614-764-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 OLD HENDERSON RD STE E212",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203652",
            "telephone_number": "614-947-0936",
            "fax_number": "614-947-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "RHONDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0867709",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.