Active NPI
Kelsey Tiller, RD, LD
- Registered Dietitian
- Georgetown, SC
National Provider Identifier
1114341708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1135
- Practice address
- 100 Roberts Rd
Georgetown, SC 29440-6898 - Phone
- (843) 485-2234
- NPI assigned
- Feb 18, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1135 | SC | Primary |
Addresses
Primary practice location
100 Roberts Rd
Georgetown, SC 29440-6898
Mailing address
100 Roberts Rd
Georgetown, SC 29440-6898
Phone (843) 485-2234
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
Organizations & group practices 1
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": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1114341708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 ROBERTS RD",
"city": "GEORGETOWN",
"state": "SC",
"postal_code": "294406898",
"telephone_number": "843-485-2234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 ROBERTS RD",
"city": "GEORGETOWN",
"state": "SC",
"postal_code": "294406898",
"telephone_number": "843-485-2234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLER",
"first_name": "KELSEY",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-18",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "SC",
"license": "1135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, SC
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- Tidelands GHS Joint Venture LLC (Tidelands Community Hospice)
- Tidelands GHS Joint Venture LLC (Tidelands Community Palliative Care)
- Tidelands Home Care LLC
- Gerald R. Tiller, M.D.
- Logan Hill Timmons, OTR/L
- Brenda Tomlin-Aubrey, CRNA
- Eddie A Towe, CRNA
- Mark E Triana, D.O.
- Trinity Counseling Agency
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.