Jana Marie Lilyerd, ANP/GNP
Individual provider Active NPI Nurse Practitioner · Appleton, MN
NPI 1710242300 · NPPES record last updated Jul 10, 2012
Key facts
- NPI
- 1710242300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R161003-3 (MN)
- Practice address
- 30 S Behl St
Appleton, MN 56208-1616 - Phone
- (320) 289-2422
- Fax
- (320) 289-1585
- NPI assigned
- Jul 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Lukes Clinic-Treasure Valley LLC
Practice addresses (Care Compare)
1210 NW 16TH St
Fruitland, ID 83619-2202
Phone (208) 452-8600
Hospital & facility affiliations
- Horizon Home Health West
- St Luke'S Regional Medical Center
- St Luke'S Nampa Medical Center
- Pioneer Nursing Home
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160629001121 | ID | Practitioner - Nurse Practitioner | 9436307485 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R161003-3 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current |
Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600
9850 W St Lukes Dr
Ste 129
Nampa, ID 83687
Phone (208) 205-7600
Interoperability endpoints
- jlilyerd40287@direct.slhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R161003-3 | MN | Yes |
Addresses
Primary practice location
30 S Behl St
Appleton, MN 56208-1616
Mailing address
30 S Behl St
Appleton, MN 56208-1616
Phone (320) 289-2422
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R161003-3 | Other | MN | MINNESOTA LICENSE IDENTIFICATION NUMBER |
Other providers in Appleton, MN
- Kylie Rose Hagen
- Jordan Rae Halvorson
- Brittany Lee Hamann
- Romulo V Kabatay
- Liebe Drug Inc
- Emily Nadolny
- Sanford Health Network
- Melissa Ann Schwendemann
- Kevin L. Skjei
- Lesa Jo Thielke
All providers in Appleton, MN · Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.