Individual provider Active NPI

Bryan Keith Tilley, DC

  • Chiropractor
  • Knoxville, TN
National Provider Identifier
1093079386
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC2564 Issued in TN
Practice address
2905 Tazewell Pike
Knoxville, TN 37918-1874
Phone
(865) 686-1600
Fax
(865) 686-3380
NPI assigned
Jul 2, 2012
Last updated
Jul 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC2564 TN Primary

Addresses

Primary practice location

2905 Tazewell Pike
Knoxville, TN 37918-1874

Mailing address

2905 Tazewell Pike
Knoxville, TN 37918-1874
Phone (865) 686-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121022000339 TN Practitioner - Chiropractic 0244480697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AhrGroup PAC ID 2769870195, 6 clinicians
Total Health and Wellness PLLCGroup PAC ID 6507122579, 8 clinicians

Practice addresses (Care Compare)

247 E Watt St
Alcoa, TN 37701-2236

801 E Watauga Ave
Suite 2
Johnson City, TN 37601-4113
Phone (423) 773-9779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Health PLLC Chiropractor CurrentSince Apr 1, 2017 Accepting new patients
Ahr Chiropractor CurrentSince Aug 21, 2023 Accepting new patients
Optimal Health PLLC CurrentSince Apr 1, 2017 Accepting new patients
Abercrombie Radiological Consultants Inc Past Accepting new patients

Locations

246 N Rankin Rd
Alcoa, TN 37701
Phone (865) 984-2001

247 E Watt St
Alcoa, TN 37701
Phone (865) 984-2001

2905 Tazewell Pike
Knoxville, TN 37918
Phone (865) 686-1600

8874 Kingston Pike
Knoxville, TN 37923
Phone (865) 690-4200

8874 Kingston Pike
Ste 202
Knoxville, TN 37923
Phone (865) 691-9055

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1093079386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TAZEWELL PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181874",
            "telephone_number": "865-686-1600",
            "fax_number": "865-686-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TAZEWELL PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181874",
            "telephone_number": "865-686-1600",
            "fax_number": "865-686-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "BRYAN",
        "middle_name": "KEITH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC2564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.