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LILY E FORMBY RD
NPI 1508439480
Dietitian, Registered in Little Rock, AR

Active since July 20, 2021
8924 KANIS RD, LITTLE ROCK, AR 72205(501) 455-2712(501) 455-2781 Get Directions Write a Review

NPPES record last updated: July 26, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 26, 2021, Jul 20, 2021 (2 updates tracked since 2021).

About Lily E Formby Rd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LILY E FORMBY RD (NPI 1508439480) is an individual dietitian, registered in Little Rock, Arkansas, licensed in Arkansas (2092) and active in the NPI registry since July 2021.

NPPES Registry Identity

NPI1508439480
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameLILY E FORMBYCredential: RD
Location Address8924 KANIS RDLittle Rock, AR 72205-6414
Mailing AddressPo Box 497Augusta, AR 72006-0497 · (870) 347-2534
Phone(501) 455-2712
Fax(501) 455-2781
Sole ProprietorNo
Enumeration DateJuly 20, 2021
Last NPPES UpdateJuly 26, 20212 updates tracked since enumeration
NPPES CertifiedJuly 26, 2021
✔ NPI 1508439480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in AR · 2092
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
8924 KANIS RD, Little Rock, AR 72205
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lily E Formby Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Lily Formby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Baptist Health Hospitals
49 mi
Nutrition, Education
1703 N BUERKLE ST
Stuttgart, AR 72160
  • Reassigned Medicare billing, Arkansas enrollment
  • 2 clinicians in this Medicare group
NPI 1982016028 (870) 674-6702

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KENNEDI TAYLOR JAMES APRN
Nurse Practitioner (Family)
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
KIZZIE DENISE HOUSTON
Nurse Practitioner (Psychiatric/Mental Health)
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
HALLE MEDLEY LPC
Counselor (Professional)
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
MS. SECOYIA S KEY LPC
Counselor (Professional)
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
STARSHA LYNN FORD CNP
Nurse Practitioner (Psychiatric/Mental Health)
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
JORDAN ALEXANDER BELLEW MS, RD
Dietitian, Registered
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
MIKAYLA LAUREN BALLARD APRN
Nurse Practitioner (Family)
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712
ARCARE
Clinic/Center (Federally Qualified Health Center (FQHC))
8924 KANIS RD
LITTLE ROCK, AR 72205
Pulaski County (501) 455-2712

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lily Formby's NPI number?

The NPI number for Lily Formby is 1508439480. It was assigned to this individual provider in the NPPES registry on July 20, 2021.

Where is Lily Formby located?

Lily Formby practices at 8924 Kanis Rd, Little Rock, AR 72205. The listed phone number is (501) 455-2712.

What is Lily Formby's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Lily Formby enrolled in Medicare?

Yes. Lily Formby is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lily Formby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lily Formby reassigns Medicare benefits to Baptist Health Hospitals (Stuttgart, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lily Formby's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lily Formby accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Lily Formby as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lily Formby was last updated on July 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.