Active NPI
Brooks Lynn Tiller, D.P.T.
- Physical Therapist
- Tullahoma, TN
National Provider Identifier
1053563569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8455
- Practice address
- 2111 N Jackson St
Suite 114
Tullahoma, TN 37388-2207 - Phone
- (931) 393-4494
- Fax
- (931) 393-4616
- NPI assigned
- Oct 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8455 | TN | Primary |
Addresses
Primary practice location
2111 N Jackson St
Suite 114
Tullahoma, TN 37388-2207
Mailing address
PO Box 681478
Franklin, TN 37068-1478
Phone (615) 591-6590
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8455 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1053563569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 681478",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370681478",
"telephone_number": "615-591-6590",
"fax_number": "615-591-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2111 N JACKSON ST",
"address_2": "SUITE 114",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373882207",
"telephone_number": "931-393-4494",
"fax_number": "931-393-4616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLER",
"first_name": "BROOKS",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-15",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "8455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tullahoma, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.