Brittanie A. Tillman, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10035 Issued in MD

Practice address

14500 Bustleton Ave Ste 1a
Philadelphia, PA 19116-1188

Phone

(215) 613-6523

Fax

(215) 613-6527

NPI assigned

Jul 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1093167033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 N CHARLES ST",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212043780",
            "telephone_number": "443-809-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 BUSTLETON AVE STE 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161188",
            "telephone_number": "215-613-6523",
            "fax_number": "215-613-6527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "BRITTANIE",
        "middle_name": "A.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-01",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012659",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "10035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DEPT. OF HEALTH- STATE BOARD EXAMINERS FOR AUD. SLP & MUSIC THERAPISTS",
            "identifier": "10035",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian M Till, MD
• L. Gayani Tillekeratne, MD
• Laurie Tillery-Russell, CRNP
• Stephanie Marie Tillery, CRNP FNP-C
• Tillman & Son'S Enterprise LLC
• Natasha Tillman
• Rasheeda Tillman
• Ryan Tillman
• Shinika Tillman
• Caitlin Nicole Tillson, MD

• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.