Individual provider Active NPI

Lillie Catherine Brannen, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1801547195
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10985 Issued in GA
Practice address
130 Tibet Ave Apt 105
Savannah, GA 31406-9029
Phone
(912) 376-0761
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10985 GA Primary

Addresses

Primary practice location

130 Tibet Ave Apt 105
Savannah, GA 31406-9029

Mailing address

130 Tibet Ave Apt 105
Savannah, GA 31406-9029
Phone (912) 376-0761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220502000172 GA Practitioner - Physician Assistant 5597152033
I20230801000503 SC Practitioner - Physician Assistant 5597152033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Plastic Surgery Associates LLCGroup PAC ID 7214171198, 5 clinicians

Practice addresses (Care Compare)

7 Mallett Way
Bluffton, SC 29910-6064
Phone (513) 543-7648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4782SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Nov 1, 2023 Accepting new patients
Pinnacle Plastic Surgery Associates LLC CurrentSince May 21, 2023 Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

1096 Ribaut Rd
Beaufort, SC 29902
Phone (843) 521-8080

7 Mallett Way
Bluffton, SC 29910
Phone (513) 543-7648

3 Progressive St
Bluffton, SC 29910
Phone (843) 548-0533

Organizations & group practices 3

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": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1801547195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TIBET AVE APT 105",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314069029",
            "telephone_number": "912-376-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 TIBET AVE APT 105",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314069029",
            "telephone_number": "912-376-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNEN",
        "first_name": "LILLIE",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.