Lilly Ida Roberts, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A01186 ANP Issued in AR

Practice address

322 Dogwood Hollow Rd
Mountain View, AR 72560-8626

Phone

(870) 269-2995

Fax

(870) 269-2991

NPI assigned

Jun 15, 2005

Last updated

Mar 11, 2020By 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 2

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Mountain Rural Health Center, IncGroup PAC ID 3870401722, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stone County Medical Center Hospital, Mountain View, AR, CCN 041310

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lilly.roberts@bmrhc.eclinicaldirectplus.com

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.

• Boston Mountain Rural Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Marshall, AR
  • NPI 1720096027
  Medicare reassignment Care Compare group NPD
• Boston Mountain Rural Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Bee Branch, AR
  • NPI 1699107623
  NPD
• Boston Mountain Rural Health Center, Inc

  dba Boston Mountain Rural Health Center Huntsville School Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Huntsville, AR
  • NPI 1972313237
  NPD
• Boston Mountain Rural Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Mountain View, AR
  • NPI 1982149662
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• White River Health System, Inc.

  dba Stone County Medical Center

  • Critical Access Hospital
  • Mountain View, AR
  • NPI 1417913419
  Care Compare affiliation

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1922003169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "MARSHALL",
            "state": "AR",
            "postal_code": "726501060",
            "telephone_number": "870-448-5733",
            "fax_number": "870-448-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 DOGWOOD HOLLOW RD",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "725608626",
            "telephone_number": "870-269-2995",
            "fax_number": "870-269-2991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2263 Hwy 65 North",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "AR",
            "postal_code": "726501266",
            "country_code": "US",
            "telephone_number": "870-448-5733",
            "fax_number": "870-448-5736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LILLY",
        "middle_name": "IDA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A01186 ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P000014273",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS OF ARKANSAS",
            "identifier": "54041B477",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chandra Dejarnette Ransom, LOTR
• Price Ransom, PT
• Marisa Paige Rector, RN
• Zoey Reeves
• Jamie Robbins
• Misty Roberts, RECOVERY ASSISTANT
• Tonya Robey, CMP
• Kassie Nicole Robinson, MS
• Austin Rogers
• John Rogers, CMP

• Nurse Practitioner in Mountain View, AR
• Providers in Mountain View, AR by specialty
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.
• 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.