Individual provider Active NPI

Cassie Marie Tilton, NP-C

  • Nurse Practitioner
  • Kirksville, MO
National Provider Identifier
1093464745
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019005388 Issued in MO
Practice address
1506 Crown Dr
Kirksville, MO 63501-2553
Phone
(660) 627-4493
NPI assigned
Mar 21, 2022
Last updated
Mar 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2019005388 MO Primary

Addresses

Primary practice location

1506 Crown Dr
Kirksville, MO 63501-2553

Mailing address

103 S Douglas Dr
Salina, KS 67401-3525
Phone (870) 416-4466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713001464 MO Practitioner - Nurse Practitioner 6204217961 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Missouri Health Council IncGroup PAC ID 1658280805, shared by 9 NPIs, 20 clinicians

Practice addresses (Care Compare)

1506 Crown Dr
Kirksville, MO 63501-2553
Phone (660) 627-4493

209 N Missouri St
Macon, MO 63552-1745
Phone (660) 395-5045

52334 S Bus Hwy 5
Milan, MO 63556
Phone (660) 265-1042

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2019005388MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Missouri Health Council, Inc. Nurse Practitioner Current Accepting new patients
Northeast Missouri Health Council Inc CurrentSince Sep 5, 2023 Accepting new patients
Northeast Missouri Health Council, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Northeast Missouri Health Council, Inc CurrentSince Sep 5, 2023 Accepting new patients
Northeast Missouri Health Council Inc CurrentSince Sep 1, 2022 Accepting new patients
Northeast Missouri Health Council, Inc. Current Accepting new patients

Locations

104 E Jackson St
Edina, MO 63537
Phone (660) 397-3517

1416 Crown Dr
Kirksville, MO 63501
Phone (660) 627-4493

1506 Crown Dr
Kirksville, MO 63501
Phone (660) 627-4493

402 W Jefferson St
Kirksville, MO 63501
Phone (660) 665-2741

209 N Missouri St
Macon, MO 63552
Phone (660) 385-4999

118 E Grand Ave
Memphis, MO 63555
Phone (660) 465-7522

52334 Business Highway 5
Milan, MO 63556
Phone (660) 265-1042

Interoperability endpoints

  • Direct secure messaging: cassie.tilton.p1@direct.nmhcinc.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1093464745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S DOUGLAS DR",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674013525",
            "telephone_number": "870-416-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 CROWN DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012553",
            "telephone_number": "660-627-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "CASSIE",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019005388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.