Individual provider Active NPI

Lily Yarbrough Condy, OTR/L

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1740612480
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT15704 Issued in FL
Practice address
1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568
Phone
(904) 858-7045
Fax
(904) 858-7047
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X OT005648 GA
Occupational Therapist 225X00000X OT15704 FL Primary

Addresses

Primary practice location

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568

Mailing address

1325 San Marco Blvd
Suite 200
Jacksonville, FL 32207-8568
Phone (904) 346-3465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925001670 FL Practitioner - Occupational Therapist in Private Practice 4385952290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Improvement activities
40
Cost
74.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT15704FLMDOccupational Therapist
OT005648GAMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jacksonville Orthopaedic Institute Inc Occupational Therapist CurrentSince Aug 10, 2015 Accepting new patients

Locations

1325 San Marco Blvd
Ste 102
Jacksonville, FL 32207
Phone (904) 557-9021

1325 San Marco Blvd
Ste 200
Jacksonville, FL 32207
Phone (904) 346-3465

Organizations & group practices 1

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1740612480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-858-7045",
            "fax_number": "904-858-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDY",
        "first_name": "LILY",
        "middle_name": "YARBROUGH",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "GA",
            "license": "OT005648",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.