Individual provider Active NPI

Cyrilla Dawn Lillie, PHARMACY TECHNICIAN

  • Pharmacy Technician
  • Traverse City, MI
National Provider Identifier
1992495709
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
5303012059 Issued in MI
Practice address
939 US Highway 31 S
Traverse City, MI 49685-8038
Phone
(231) 943-9288
Fax
(231) 943-8747
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 5303012059 MI Primary

Addresses

Primary practice location

939 US Highway 31 S
Traverse City, MI 49685-8038

Mailing address

939 US Highway 31 S
Traverse City, MI 49685-8038
Phone (231) 943-9288

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5303012059MIMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Michigan Inc PastSince May 21, 2023 Accepting new patients
Rite Aid of Michigan Inc PastSince May 21, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1992495709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 US HIGHWAY 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858038",
            "telephone_number": "231-943-9288",
            "fax_number": "231-943-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 US HIGHWAY 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858038",
            "telephone_number": "231-943-9288",
            "fax_number": "231-943-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIE",
        "first_name": "CYRILLA",
        "middle_name": "DAWN",
        "credential": "PHARMACY TECHNICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MI",
            "license": "5303012059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.