Individual provider Active NPI

Daphne Ann Tillman-Jones, SLP

  • Speech-Language Pathologist
  • Waycross, GA
National Provider Identifier
1033557186
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP003805 Issued in GA
Practice address
2927 Blue Jay TRL
Waycross, GA 31501-7678
Phone
(912) 288-3574
NPI assigned
Jun 11, 2013
Last updated
Jun 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP003805 GA Primary

Addresses

Primary practice location

2927 Blue Jay TRL
Waycross, GA 31501-7678

Mailing address

2927 Blue Jay TRL
Waycross, GA 31501-7678
Phone (912) 288-3574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SLP003805GAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1033557186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2927 BLUE JAY TRL",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315017678",
            "telephone_number": "912-288-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 BLUE JAY TRL",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315017678",
            "telephone_number": "912-288-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN-JONES",
        "first_name": "DAPHNE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.