Individual provider Active NPI

Ian Anderl Lillie

  • Case Manager/Care Coordinator
  • Newport, OR
National Provider Identifier
1750969481
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
51 SW Lee St
Newport, OR 97365-3823
Phone
(541) 574-5960
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

51 SW Lee St
Newport, OR 97365-3823

Mailing address

36 SW Nye St
Newport, OR 97365-3821
Phone (541) 265-0445

Other practice location 1

4422 NE Devils Lake Blvd Ste 2
Lincoln City, OR 97367-5000
Phone (541) 265-4196

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

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1750969481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-265-0445",
            "fax_number": "844-760-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SW LEE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653823",
            "telephone_number": "541-574-5960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 NE Devils Lake Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Lincoln City",
            "state": "OR",
            "postal_code": "973675000",
            "country_code": "US",
            "telephone_number": "541-265-4196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLIE",
        "first_name": "IAN",
        "middle_name": "ANDERL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.