Active NPI
Lillian May O'Drain, PA-C
- Physician Assistant
- Fort Myers, FL
National Provider Identifier
1992954820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9102183
- Practice address
- 9241 Park Royal Dr
Fort Myers, FL 33908-9204 - Phone
- (239) 984-9859
- NPI assigned
- Sep 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | PA9102183 | FL | |
| Physician Assistant | 363A00000X | PA9102183 | FL | Primary |
Addresses
Primary practice location
9241 Park Royal Dr
Fort Myers, FL 33908-9204
Mailing address
PO Box 152387
Cape Coral, FL 33915-2387
Phone (239) 229-6453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201218000030 | FL | Practitioner - Physician Assistant | 6002228913 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9102183 | FL | MD | Hospitalist Physician |
Organizations & group practices 1
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": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1992954820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 152387",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339152387",
"telephone_number": "239-229-6453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9241 PARK ROYAL DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339089204",
"telephone_number": "239-984-9859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'DRAIN",
"first_name": "LILLIAN",
"middle_name": "MAY",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "FL",
"license": "PA9102183",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9102183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.