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MR. GLEN NEAL LILLY PA-C NPI 1275935934


NPI Information

NPI: 1275935934
Provider Name: MR. GLEN NEAL LILLY, PA-C
Classification: Physician Assistant - 363A00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
4301 DICK POND RD
MYRTLE BEACH, SC
ZIP 29588
Phone: (843) 652-8100
Get Directions

MR. Glen Neal Lilly, PA-C is a physician assistant in Myrtle Beach, SC with 10 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MR. Glen Neal Lilly, PA-C NPI is 1275935934. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduation Year:2014

The provider's business location address is:

4301 DICK POND RD
MYRTLE BEACH, SC
ZIP 29588-807
Phone: (843) 652-8100
Fax: (843) 652-8122

The NPI 1275935934 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Hemoglobin a1c level (HCPCS:83036)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Automated urinalysis test (HCPCS:81003)

The enumeration date for this NPI number is 9/24/2014 and was last updated on 3/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician Assistant2189SOUTH CAROLINAYes
2363A00000XPhysician AssistantTL2189SOUTH CAROLINANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12189OTHERSOUTH CAROLINAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.