Holli Lillard is a medicare enrolled "Clinic/center - Physical Therapy" provider in Imboden, Arkansas. Their current practice location is
5552 Us Hwy 63, Suite B, Imboden, Arkansas. You can reach out to their office (for appointments etc.) via phone at
(870) 869-2770.
Holli Lillard is licensed to practice in Arkansas (license number PT2712) and it also participates in the medicare program. Holli Lillard
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1679071302.
Healthcare Provider's Profile
| Full Name | Holli Lillard |
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| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 5552 Us Hwy 63, Imboden, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1679071302
- Provider Enumeration Date: 01/29/2018
- Last Update Date: 05/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 5294097473
- Enrollment ID: O20180328001403
Medical Identifiers
Medical identifiers for Holli Lillard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679071302 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | PT2712 (Arkansas) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | PT2712 (Arkansas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Holli Lillard acts as a billing entity for following providers:
| Provider Name | Bryan R Declerk |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1558806299
PECOS PAC ID: 1456637446
Enrollment ID: I20170803001435 |
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| Provider Name | Holli Dawn Lillard |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1134639222
PECOS PAC ID: 5890051304
Enrollment ID: I20171115002394 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Holli Lillard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Holli Lillard
Po Box 334,
Imboden, AR 72434-0334
Ph: (870) 869-2770 | Holli Lillard
5552 Us Hwy 63, Suite B,
Imboden, AR 72434
Ph: (870) 869-2770 |
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