Individual provider Active NPI

Lillian May O'Drain, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1992954820
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102183 Issued in FL
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

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
PA9102183FLMDHospitalist 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

Verify at the official NPI Registry.