Lily Obstetrics and Gynecology, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

050041 Issued in GA

Legal business name

LILY OBSTETRICS AND GYNECOLOGY, LLC

Practice address

7000 Wellness Way
Suite 7220
St Simons Island, GA 31522-2286

Phone

(912) 638-1801

Fax

(912) 638-1821

NPI assigned

Jul 5, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Tina F Mitchell, MDNPI 1437128485

Title

Owner/President

Phone

(912) 638-1801

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tina F Mitchell, M.D.

  • Obstetrics & Gynecology Physician
  • Brunswick, GA
  • NPI 1437128485
  Medicare reassignment NPD Authorized official
• Marie Owsley Easterlin, M.D.

  • Obstetrics & Gynecology Physician
  • Brunswick, GA
  • NPI 1003008111
  NPD (past)

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1962799486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 WELLNESS WAY",
            "address_2": "SUITE 7220",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222286",
            "telephone_number": "912-638-1801",
            "fax_number": "912-638-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 WELLNESS WAY",
            "address_2": "SUITE 7220",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222286",
            "telephone_number": "912-638-1801",
            "fax_number": "912-638-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY OBSTETRICS AND GYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "912-638-1801",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "050041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003118614A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Ach Kidwell, PSC, CTRS
• Kelly M. Kruk, D.O., D.A.
• Kendra Lawrence, PTA
• Life'S Answers Counseling Center
• Scott Lillibridge, MD
• John Alexander Limburg, M.D.
• Live Long Well Care, LLC
• Matthew M Luce, PHARM.D.
• Carole Lyons, PNP
• Savannah E Lyons, DPT, PT

• Obstetrics & Gynecology Physician in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.