Individual provider Active NPI

Victoria Lynn Lilly

  • Orthopedic Physical Therapist
  • Yukon, OK
National Provider Identifier
1881464691
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
6537 Issued in OK
Practice address
740 S Mustang Rd
Yukon, OK 73099-6777
Phone
(405) 494-7070
NPI assigned
Jan 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 6537 OK Primary

Addresses

Primary practice location

740 S Mustang Rd
Yukon, OK 73099-6777

Mailing address

1316 Shannon LN
Edmond, OK 73034-8152
Phone (405) 202-7933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240516000874 OK Practitioner - Physical Therapist in Private Practice 1355782723 Reassigns benefits to 1 organization
I20250306000810 IN Practitioner - Physical Therapist in Private Practice 1355782723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Wellness Team LLCGroup PAC ID 5890142145, 41 clinicians

Practice addresses (Care Compare)

1703 W 86TH St
Indianapolis, IN 46260-2002
Phone (866) 360-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6537OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
My Wellness Team LLC CurrentSince Feb 26, 2025 Accepting new patients
HPC Holdings LLC Orthopedic CurrentSince May 2, 2024 Accepting new patients
Human Performance Center 7 PC PastSince Jan 7, 2024 Accepting new patients

Locations

4411 Park Place Dr
Fort Wayne, IN 46845
Phone (260) 205-8451

911 E 86th St
Ste 103
Indianapolis, IN 46240
Phone (812) 267-2841

740 S Mustang Rd
Yukon, OK 73099
Phone (405) 494-7070

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1881464691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 SHANNON LN",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730348152",
            "telephone_number": "405-202-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S MUSTANG RD",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996777",
            "telephone_number": "405-494-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "VICTORIA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OK",
            "license": "6537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yukon, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.