Kimberly Dawn Lilley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000024453 Issued in TN

Practice address

1018 Chase Dr
Johnson City, TN 37604-1402

Phone

(423) 282-3379

Fax

(423) 430-6227

NPI assigned

Feb 11, 2008

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

Other names 1

• Kimberly Dawn Green, Young Former name

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Catalyst Health Solutions,LLCGroup PAC ID 0749615672, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Catalyst Health Solutions,LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Johnson City, TN
  • NPI 1184150229

  VA

  Medicare reassignment Care Compare group NPD
• Advocate Integrated Medical

  • Adult Medicine Physician
  • Johnson City, TN
  • NPI 1720854037
  NPD

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1700064904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 CHASE DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041402",
            "telephone_number": "423-282-3379",
            "fax_number": "423-430-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 CHASE DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041402",
            "telephone_number": "423-282-3379",
            "fax_number": "423-430-6227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "926 W Oakland Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376041445",
            "country_code": "US",
            "telephone_number": "423-282-3379",
            "fax_number": "423-430-6227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000024453",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000161066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "GREEN, YOUNG",
            "middle_name": "DAWN",
            "credential": "BSN-RN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Life Well Pharmacy, LLC
• Light Connection Inc
• Madison Ramsey Light, M.S., CCC-SLP
• Lighthouse Independent Living
• Sandra Ligocki
• David R Lilly, PT
• Kristi Lynnette Lilly, BS
• Limestone Diagnostic Center, LLC
• Lincare Inc
• Brenda Lindsey

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.