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MR. BUDDY WAYNE LILE M.D. NPI 1104858612


NPI Information

NPI: 1104858612
Provider Name: MR. BUDDY WAYNE LILE, M.D.
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Individual

Specialization: Psychiatry

Organization: AMHERST H. WILDER FOUNDATION

PECOS Registration: Yes

Address:
550 MAIN STREET
SUITE 230
NEW BRIGHTON, MN
ZIP 55112
Phone: (612) 326-7558
Get Directions

MR. Buddy Wayne Lile, M.D. is a psychiatry psychiatry neurology in New Brighton, MN with 30 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. MR. Buddy Wayne Lile, M.D. NPI is 1104858612. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year:1994

The provider's business location address is:

550 MAIN STREET
SUITE 230
NEW BRIGHTON, MN
ZIP 55112
Phone: (612) 326-7558
Fax: (612) 454-2087

The NPI 1104858612 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 enumeration date for this NPI number is 7/7/2006 and was last updated on 10/15/2015.


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
12084P0800XPsychiatry & NeurologyPsychiatry042-0010705VERMONTNo
22084P0800XPsychiatry & NeurologyPsychiatry49329MINNESOTAYes

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
11010386MEDICAIDVERMONT
2042-0010705OTHERVERMONTVERMONT STATE LICENSE
31010386MEDICAIDMINNESOTA
4BL4764379OTHERVERMONTDEA REGISTRATION
5G48894MEDICARE UPINVERMONT
6260002670MEDICARE PINMINNESOTA
7VN3350MEDICARE UPINMINNESOTA

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: 11/14/2023

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.