Active NPI
Lily Wells, RD
- Registered Dietitian
- Mountain BRK, AL
National Provider Identifier
1760251763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 4035
- Practice address
- 2560 Beverly Dr
Mountain BRK, AL 35223-1116 - Phone
- (443) 252-0101
- NPI assigned
- Jan 1, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 4035 | AL | Primary |
Addresses
Primary practice location
2560 Beverly Dr
Mountain BRK, AL 35223-1116
Mailing address
2560 Beverly Dr
Mountain BRK, AL 35223-1116
Phone (443) 252-0101
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4035 | AL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1760251763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2560 BEVERLY DR",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352231116",
"telephone_number": "443-252-0101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 BEVERLY DR",
"city": "MOUNTAIN BRK",
"state": "AL",
"postal_code": "352231116",
"telephone_number": "443-252-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "LILY",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-01",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AL",
"license": "4035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain BRK, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.