Individual provider Active NPI

Lily Martin, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1679363295
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66657 Issued in HI
Practice address
1294 S Jones Blvd
Las Vegas, NV 89146-1284
Phone
(702) 877-1887
Fax
(702) 877-4536
NPI assigned
May 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66657 HI Primary

Addresses

Primary practice location

1294 S Jones Blvd
Las Vegas, NV 89146-1284

Mailing address

1294 S Jones Blvd
Las Vegas, NV 89146-1284
Phone (702) 877-1887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251118002818 AZ Practitioner - Nurse Practitioner 8426549346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Akdhc LLCGroup PAC ID 8123912136, 125 clinicians

Practice addresses (Care Compare)

9700 N 91St St
Suite A103
Scottsdale, AZ 85258-5077
Phone (480) 551-1059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
66657HIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Akdhc, LLC CurrentSince Nov 10, 2025 Accepting new patients
Akdhc Surgery Center, LLC Current Accepting new patients
Akdhc, LLC Current Accepting new patients
Akdhc, LLC CurrentSince Nov 10, 2025 Accepting new patients

Locations

3320 N 2nd St
Phoenix, AZ 85012
Phone (602) 200-8288

9700 N 91st St
Ste A103
Scottsdale, AZ 85258
Phone (480) 551-1059

Interoperability endpoints

  • Direct secure messaging: lily.martin.1@11625.direct.athenahealth.com

Organizations & group practices 4

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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1679363295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461284",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461284",
            "telephone_number": "702-877-1887",
            "fax_number": "702-877-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LILY",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "66657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.