Active NPI
Amber Corrin Tillman
- Behavior Technician
- Omaha, NE
National Provider Identifier
1114582657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-60817
- Practice address
- 7905 L St Ste 230
Omaha, NE 68127-1732 - Phone
- (402) 512-4296
- Fax
- (866) 726-5366
- NPI assigned
- May 9, 2019
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-60817 | NC | Primary |
Addresses
Primary practice location
7905 L St Ste 230
Omaha, NE 68127-1732
Mailing address
16941 N Eagle River Loop Rd
Eagle River, AK 99577-7824
Phone (907) 726-5330
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-60817 | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579132800000",
"number": "1114582657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16941 N EAGLE RIVER LOOP RD",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995777824",
"telephone_number": "907-726-5330",
"fax_number": "907-726-5366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7905 L ST STE 230",
"city": "OMAHA",
"state": "NE",
"postal_code": "681271732",
"telephone_number": "402-512-4296",
"fax_number": "866-726-5366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "AMBER",
"middle_name": "CORRIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-09",
"last_updated": "2020-01-16",
"certification_date": "2020-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NC",
"license": "RBT-18-60817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.