Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lillykutty Abraham Modoor, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1013155969

Lillykutty Abraham Modoor, NURSEPRACTITIONER is a Nurse Practitioner in Winston Salem, North Carolina. Qualified in 2012, 14 years ago. Practices with Daymark Recovery Services Inc, a 129-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
14
Licensed in
NC
In the registry since
2009
Specialties on file
3
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Practice location Address checks out

650 Highland Ave Ste 100
Winston Salem, NC 27101-4304
Phone: (336) 607-8523
Fax: (336) 773-0916
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 725 Highland Ave Unit 116, Winston Salem, NC 27101-4181 — (336) 703-3250

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5004280 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence 5004280 (NC)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 5004280 (NC)

Record details

NPI number1013155969
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedJanuary 30, 2009
Last updated in NPPESFebruary 6, 2023
Certification dateFebruary 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Daymark Recovery Services Inc — 129 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Winston Salem