Larry Lee Lilley III, NNP

Primary specialty

Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X

License

0001190201 Issued in VA

Practice address

627 Aragona Dr
Vinton, VA 24179-2807

Phone

(540) 342-1004

NPI assigned

Mar 14, 2010

Last updated

Mar 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268524800000",
    "number": "1700100146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 ARAGONA DR",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241792807",
            "telephone_number": "540-342-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 ARAGONA DR",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241792807",
            "telephone_number": "540-342-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "LARRY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-14",
        "last_updated": "2010-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "VA",
            "license": "0001190201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neonatal Intensive Care Registered Nurse in Vinton, VA
• Providers in Vinton, VA by specialty
• Neonatal Intensive Care Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.