Lily R Brunner, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10005210A Issued in IN

Practice address

4209 Gateway Blvd
Newburgh, IN 47630-8900

Phone

(812) 426-9855

Fax

(812) 858-4536

NPI assigned

Feb 19, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1771459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1851244719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308900",
            "telephone_number": "812-426-9855",
            "fax_number": "812-858-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308900",
            "telephone_number": "812-426-9855",
            "fax_number": "812-858-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "LILY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-19",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10005210A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Rae Pike Brown, M.D.
• Micahel W Brown, DDS
• Bruce P Williams MD PC
• Shelby Ann Brummer, RBT
• Kelsey Marie Bruner, RD
• Kathryn A Bryan, MD
• Jessica Buchan
• Jill Buck, LCSW
• Aryn Buckman, RBT
• Ashley Buckman, RBT

• Physician Assistant in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.