LILLYKUTTY A MODOOR NURSE PRACTITIONER NPI 1013155969

Nurse Practitioner (Psychiatric/Mental Health) in Winston Salem, NC

NPI 1013155969 Individual Female Years of Experience 10 Nurse Practitioner Psychiatric/Mental Health PECOS Enrolled Accepts Medicare Approved Payment

About LILLYKUTTY MODOOR

Lillykutty Modoor is a provider established in Winston Salem, North Carolina and her medical specialization is nurse practitioner (psychiatric/mental health) with more than 10 years of experience. The NPI number of Lillykutty Modoor is 1013155969 and was assigned on January 2009. The practitioner's primary taxonomy code is 363LP0808X with license number 5004280 (NC). The provider is registered as an individual and her NPI record was last updated one year ago.

A nurse practitioner (NP) like Lillykutty A Modoor Nurse Practitioner is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Lillykutty Modoor is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Lillykutty Modoor is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

NPI

1013155969

Provider Name LILLYKUTTY A MODOOR NURSE PRACTITIONER
Provider Location Address650 HIGHLAND AVE STE 100 WINSTON SALEM, NC 27101
Provider Mailing AddressPO BOX 60447 CHARLOTTE, NC 28260
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2012
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date01-30-2009
Last Update Date12-02-2020


Primary Taxonomy

Taxonomy Code363LP0808X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationPsychiatric/Mental Health
License No.5004280
License StateNC

Business Address

LILLYKUTTY A MODOOR NURSE PRACTITIONER
650 HIGHLAND AVE STE 100
WINSTON SALEM, NC
ZIP 27101
Phone: (336) 607-8523
Fax: (336) 773-0916

Get Directions


Mailing Address

LILLYKUTTY A MODOOR NURSE PRACTITIONER
PO BOX 60447
CHARLOTTE, NC
ZIP 28260
Phone: (336) 277-1800
Fax: (336) 277-6981



Secondary Locations

3333 Silas Creek Pkwy
Winston Salem, NC 27103
(336) 277-1800

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner5004280NCNo

Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily5004280NCNo

Taxonomy Description: Not Available

Other Providers at the same location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1083763536DAYMARK RECOVERY SERVICES INC
Organization
Clinic/Center (Multi-Specialty)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1508169889 DONNA LUCILLE ROBERSON MS, LCAS-A
Individual
Counselor (Addiction (Substance Use Disorder))650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1740719202 FREDA MARIA DAVIS
Individual
Social Worker (Clinical)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1790807535DAYMARK RECOVERY SERVCIES INC
Organization
Community/Behavioral Health650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1518369065 DERRICK FOWLER LCAS-A
Individual
Counselor (Addiction (Substance Use Disorder))650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1265925465 ALEXANDRA LUNDBERG LPCA
Individual
Counselor (Professional)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1225385289MRS. ANNETTE N GAITHER LCSW-A, LCAS-A
Individual
Social Worker (Clinical)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1104449305 MATTHEW REILAND LCAS-A, LCSW-A
Individual
Social Worker (Clinical)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1104034883DAYMARK RECOVERY SERVICES INC
Organization
Psychiatry & Neurology (Psychiatry)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(333) 660-7852
1417560970 ANEE KAUR PA
Individual
Physician Assistant650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523
1508435793 CINDY WEAVER ARRINGTON
Individual
Counselor (Professional)650 HIGHLAND AVE STE 100
WINSTON SALEM, NC 27101
(336) 607-8523

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.