Patricia E Lally, DO MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1529 Issued in WV

Practice address

645 Kanawha Ave
Rainelle, WV 25962-1013

Phone

(304) 438-6188

Fax

(304) 438-4037

NPI assigned

Feb 1, 2006

Last updated

Aug 27, 2012By the provider in NPPES

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patricia.lally.1@12396.direct.athenahealth.com
• Direct secure messaging: patricialally@rmc.allscriptsdirect.net

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.

• Rainelle Medical Center Inc

  dba Meadow Bridge Clinic

  • Federally Qualified Health Center (FQHC)
  • Meadow Bridge, WV
  • NPI 1093883324
  Medicare reassignment NPD
• Rainelle Medical Center, Inc.

  dba Maxwelton Health Center

  • Federally Qualified Health Center (FQHC)
  • Maxwelton, WV
  • NPI 1528417946
  Medicare reassignment NPD
• Rainelle Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Rainelle, WV
  • NPI 1437227766
  NPD
• Rainelle Medical Center, Inc.

  dba Lewisburg Behavioral Health

  • Federally Qualified Health Center (FQHC)
  • Caldwell, WV
  • NPI 1578399085
  NPD

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1871564245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 KANAWHA AVE",
            "city": "RAINELLE",
            "state": "WV",
            "postal_code": "259621013",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 KANAWHA AVE",
            "city": "RAINELLE",
            "state": "WV",
            "postal_code": "259621013",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-4037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLY",
        "first_name": "PATRICIA",
        "middle_name": "E",
        "credential": "DO MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "1529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5336168",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110398000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "P99827",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1719217",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00067677",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tearsa R. Keatley, PA-C
• Cheri Keener
• Lisa Marie Kessler, D.O.
• Cierra Marie Knight
• Kroger Limited Partnership I (Kroger Pharmacy)
• Carol Ann Lewis, LPC
• Shelly Lewis
• Teresa Lynn Lindsey
• Derik Austin Livingston
• Sierra Mae Livingston

• Pediatrics Physician in Rainelle, WV
• Providers in Rainelle, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.