Mary Kathryn Lilly, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2718922 Issued in FL

Practice address

5041 N 12TH Ave
Pensacola, FL 32504-8916

Phone

(850) 433-2155

NPI assigned

Jun 20, 2017

Last updated

Nov 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gastroenterology Associates of Pensacola PA

  • Gastroenterology Physician
  • Pensacola, FL
  • NPI 1235223785
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1669992830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 TEMPLEMORE DR",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325334800",
            "telephone_number": "850-450-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 N 12TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048916",
            "telephone_number": "850-433-2155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Thomson Dr",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245011118",
            "country_code": "US",
            "telephone_number": "434-200-6085",
            "fax_number": "434-200-6086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174962",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2718922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lighthouse Health Plan, LLC
• Lil Dental, P.a. (Sorrento Dental Care)
• William R Lile, DO
• Rachel Elizabeth Lill
• John S Lilly, RN
• Linh Lim
• Shirlee Lim, BCBA
• Zachary Lin, DO
• Lincare Inc.
• Lauren Elizabeth Linda, CCSH

• Family Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.