Active NPI
Patrick L Lillard, M.D.
- Psychiatry Physician
- Ft Gordon, GA
National Provider Identifier
1881742468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 46721
- Practice address
- 300 E. Hospital Road
Room 13a-10
Ft Gordon, GA 30905-5650 - Phone
- (706) 305-7086
- Fax
- (706) 787-0105
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 46721 | NC | Primary |
Addresses
Primary practice location
300 E. Hospital Road
Room 13a-10
Ft Gordon, GA 30905-5650
Mailing address
300 E. Hospital Road, 12 West
12 West
Fort Gordon, GA 30905
Phone (706) 305-7086
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8951821 | Medicaid | NC | |
| 130G7 | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46721 | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Counseling | Past | Accepting new patients | |
| Skyland Behavioral Health Associates, PA | Past | Accepting new patients | |
| Crossroads Counseling Center, Inc. | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Hickory, NC
- NPI 1043209711
-
- Professional Counselor
- Hickory, NC
- NPI 1487670279
-
- Clinical Psychologist
- Asheville, NC
- NPI 1891868402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1881742468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E. HOSPITAL ROAD, 12 WEST",
"address_2": "12 WEST",
"city": "FORT GORDON",
"state": "GA",
"postal_code": "30905",
"telephone_number": "706-305-7086",
"fax_number": "706-787-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E. HOSPITAL ROAD",
"address_2": "ROOM 13A-10",
"city": "FT GORDON",
"state": "GA",
"postal_code": "309055650",
"telephone_number": "706-305-7086",
"fax_number": "706-787-0105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLARD",
"first_name": "PATRICK",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "46721",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8951821",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "130G7",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft Gordon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.