Active NPI
Jacob Ross Lilly, PHARMD
- Pharmacist
- Beckley, WV
National Provider Identifier
1740765882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0007913
- Practice address
- 252 Rural Acres Dr
Beckley, WV 25801-3503 - Phone
- (304) 252-8324
- NPI assigned
- Sep 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0007913 | WV | Primary |
Addresses
Primary practice location
252 Rural Acres Dr
Beckley, WV 25801-3503
Mailing address
252 Rural Acres Dr
Beckley, WV 25801-3503
Phone (304) 252-8324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP0007913 | Other | WV | PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP0007913 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537833600000",
"number": "1740765882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 RURAL ACRES DR",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013503",
"telephone_number": "304-252-8324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 RURAL ACRES DR",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013503",
"telephone_number": "304-252-8324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "JACOB",
"middle_name": "ROSS",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-25",
"last_updated": "2018-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0007913",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "RP0007913",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.