Individual provider Active NPI

Desiree Lilley, FNP-C

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1790550408
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024188656 Issued in VA
Practice address
704 Thimble Shoals Blvd Ste 700
Newport News, VA 23606-4544
Phone
(757) 873-2000
Fax
(757) 873-2003
NPI assigned
Nov 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024188656 VA Primary

Addresses

Primary practice location

704 Thimble Shoals Blvd Ste 700
Newport News, VA 23606-4544

Mailing address

704 Thimble Shoals Blvd Ste 700
Newport News, VA 23606-4544
Phone (757) 873-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613002780 VA Practitioner - Nurse Practitioner 1153864574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oyster Point Family Practice IncGroup PAC ID 9436137296, 5 clinicians

Practice addresses (Care Compare)

704 Thimble Shoals Blvd
Suite 700
Newport News, VA 23606-4544
Phone (757) 873-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024188656VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oyster Point Family Practice, Inc CurrentSince Jan 8, 2024 Accepting new patients

Locations

704 Thimble Shoals Blvd
Ste 700
Newport News, VA 23606
Phone (757) 586-5256

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1790550408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 THIMBLE SHOALS BLVD STE 700",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064544",
            "telephone_number": "757-873-2000",
            "fax_number": "757-873-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 THIMBLE SHOALS BLVD STE 700",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064544",
            "telephone_number": "757-873-2000",
            "fax_number": "757-873-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "DESIREE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-22",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024188656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.