Kayla Brooke Tiller, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202008754 Issued in VA

Practice address

340 E Jackson St
Gate City, VA 24251-3526

Phone

(276) 386-6118

Fax

(276) 386-2684

NPI assigned

Oct 26, 2017

Last updated

Aug 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Scott County Schools

  • Local Education Agency (LEA)
  • Gate City, VA
  • NPI 1295741973
  NPD (past)
• Wise County Public Schools

  • School Nurse Practitioner
  • Wise, VA
  • NPI 1003922972

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1093227407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 ADDINGTON FRAME RD",
            "city": "NICKELSVILLE",
            "state": "VA",
            "postal_code": "24271",
            "telephone_number": "423-306-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 E JACKSON ST",
            "city": "GATE CITY",
            "state": "VA",
            "postal_code": "242513526",
            "telephone_number": "276-386-6118",
            "fax_number": "276-386-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "KAYLA",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roderick Malcolm Smith
• Southwest Virginia Child Development Services
• Southwest Virginia Child Development Services Corp
• Templeton Dentistry, PC
• Therapy Innovations Inc (1St Step Rehab)
• Karen Bryant Valk, FNP
• Virginia CVS Pharmacy LLC (CVS Pharmacy # 07343)
• Walgreen Co (Broadwater Drug #15669, Powered by Walgreens)
• Jennifer Lynn Wallace, OTR/L
• Farah Ester Williams, PHD

• Speech-Language Pathologist in Gate City, VA
• Providers in Gate City, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.