MARY KATHRYN LILLY APRN
NPI 1669992830
Nurse Practitioner - Family in Pensacola, FL

Q: What is Mary Lilly's NPI number?

The NPI number for Mary Lilly is 1669992830. It was assigned to this individual provider in the NPPES registry on June 20, 2017.

Q: What is Mary Lilly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Lilly was last updated on November 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since June 20, 2017PECOS Enrolled

5041 N 12TH AVE, PENSACOLA, FL 32504(850) 433-2155 Get Directions Write a Review

NPPES record last updated: November 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 17, 2023, Apr 10, 2019, Jun 20, 2017 (3 updates tracked since 2017).

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About Mary Kathryn Lilly Aprn NPPES

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

MARY KATHRYN LILLY APRN (NPI 1669992830) is an individual family provider in Pensacola, Florida, licensed in Florida (2718922) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lynchburg.

NPPES Registry Identity

NPI1669992830

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARY KATHRYN LILLYCredential: APRN

Location Address5041 N 12TH AVEPensacola, FL 32504-8916

Mailing Address1523 Templemore DrCantonment, FL 32533-4800 · (850) 450-3942

Phone(850) 433-2155

Sole ProprietorNo

Enumeration DateJune 20, 2017

Last NPPES UpdateNovember 17, 20233 updates tracked since enumeration

NPPES CertifiedNovember 17, 2023

✔ NPI 1669992830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in FL · 2718922✔ Licensed in VA · 0024174962

5041 N 12TH AVE, Pensacola, FL 32504

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Secondary Practice Location 1

Location 11701 Thomson DrLynchburg, VA 24501-1118 · Phone (434) 200-6085 · Fax (434) 200-6086

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Kathryn Lilly Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

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

LAURA JANE DERBY ARNP

Nurse Practitioner