Stephanie Thressa Lilly

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1289 Robert C Byrd Dr.,
Suite 4
Crab Orchard, WV 25827-2580

Phone

(304) 253-8979

NPI assigned

Mar 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• PNB

  • Case Management Agency
  • Crab Orchard, WV
  • NPI 1831645464
  NPD (past)

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1962087510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 COOL LN",
            "city": "SHADY SPRING",
            "state": "WV",
            "postal_code": "259188704",
            "telephone_number": "304-763-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 ROBERT C BYRD DR.,",
            "address_2": "SUITE 4",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258272580",
            "telephone_number": "304-253-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "STEPHANIE",
        "middle_name": "THRESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Crab Orchard, WV
• Providers in Crab Orchard, WV by specialty
• Case Manager/Care Coordinator in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.