SARA BETH LILES (NPI# 1013473180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013473180 |
| Entity Type | Individual |
| Full Name | SARA BETH LILES |
| Practice Address |
4414 Lake Boone Trl Ste 108 Raleigh NC 27607-7522 |
| Mailing Address |
43 Cedar Hollow Dr Garner NC 27529-7595 |
| Practice Telephone | 9197842300 |
| Practice Fax Number | 9197842301 |
| Mailing Telephone | 9194149211 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5011481 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
LILE-0PUM9U | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4414 LAKE BOONE TRL STE 108 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-7522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811960412 | Stephen Wayne Smith | Internal Medicine | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2006-02-13 |
| 1871065656 | Morgan Elaine Schultingkemper | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2018-12-18 |
| 1376058024 | Kerri Michele Jones | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2017-12-04 |
| 1871988097 | Kimberly A Trinh | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2015-04-03 |
| 1316386303 | Matthew Edward Gibson | Surgery | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607 | 2013-06-23 |
| 1952745242 | Ryan Joseph Meehan | Surgery | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2013-04-17 |
| 1770547580 | Brandy Cruse Wilson | Physician Assistant | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607-7522 | 2006-04-17 |
| 1427027242 | Suman M Wasan | Internal Medicine | 4414 Lake Boone Trl Ste 108, Raleigh, NC 27607 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558990 | Munira Amirali Ward | Nurse Practitioner | 2617 Valley Haven Dr, Raleigh, NC 27603-3197 | 2020-11-03 |
| 1710598644 | Nicole Dora Licato | Nurse Practitioner | 7200 Creedmoor Rd Ste 208, Raleigh, NC 27613-1711 | 2020-08-13 |
| 1316561178 | Mintoria Lynette Stockton | Nurse Practitioner | 8332 Mcguire Dr, Raleigh, NC 27616-5682 | 2020-06-07 |
| 1700407103 | Sadonna Marlene Sawyer | Nurse Practitioner | 3311 Grove Crabtree Cres Apt 122, Raleigh, NC 27613-3063 | 2020-04-27 |
| 1447879903 | Christapher Frank | Nurse Practitioner | 2034 Wesvill Court, Suite 320, Raleigh, NC 28326 | 2020-04-14 |
| 1265065015 | Shubham Tyagi | Nurse Practitioner | Duke Urgent Care Brier Creek, 10211 Alm Street Suite 1200, Raleigh, NC 27617-2761 | 2020-02-20 |
| 1073163812 | Taylor Brooke Lawrence | Nurse Practitioner | 10208 Cerny St Ste 301, Raleigh, NC 27617-1000 | 2019-09-13 |
| 1811456320 | Elizabeth Campbell Mcgrath | Nurse Practitioner | 2615 Lake Dr Ste 201, Raleigh, NC 27607-6694 | 2019-03-14 |
| 1922578541 | Dorothy Nwizu | Nurse Practitioner | 608 Kavkaz St, Raleigh, NC 27610-3176 | 2018-11-26 |
| 1265900013 | Patricia-marie Edge Odom | Nurse Practitioner | 3000 New Bern Ave Ste G100, Raleigh, NC 27610-1231 | 2018-11-09 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.