NPIMap

Individual provider Active NPI

Harry R Lively, M.D.

  • Cardiovascular Disease Physician
  • Visalia, CA
National Provider Identifier
1922154863
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G56294 Issued in CA
Practice address
119 S Locust St
Ste B
Visalia, CA 93291-6251
Phone
(559) 749-0223
Fax
(559) 749-0886
NPI assigned
Jan 25, 2007
Last updated
May 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G56294 CA Primary

Addresses

Primary practice location

119 S Locust St
Ste B
Visalia, CA 93291-6251

Mailing address

PO Box 2709
Visalia, CA 93279-2709
Phone (559) 749-0223

Other identifiers 1

IdentifierTypeStateIssuer
00G562940MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081113000346 CA Practitioner - Cardiovascular Disease (Cardiology) 4385704881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Perelman School of Med at the University of Pennsylvania, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaweah Delta Health Care DistrictGroup PAC ID 6608778790, 110 clinicians

Practice addresses (Care Compare)

325 S Willis St
Visalia, CA 93291-6105
Phone (559) 624-4080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G56294CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District Current Accepting new patients
Kaweah Delta Health Care District CurrentSince May 1, 2016 Accepting new patients
Kaweah Delta Health Care District CurrentSince May 1, 2016 Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients

Locations

325 S Willis St
Visalia, CA 93291
Phone (559) 624-4080

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

820 S Akers St
Ste 130
Visalia, CA 93277
Phone (516) 301-0937

840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1922154863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2709",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932792709",
            "telephone_number": "559-749-0223",
            "fax_number": "559-749-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S LOCUST ST",
            "address_2": "STE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916251",
            "telephone_number": "559-749-0223",
            "fax_number": "559-749-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "HARRY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G56294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G562940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.