Stephen B Tilley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C4672 Issued in AR

Practice address

5905 R St
Little Rock, AR 72207

Phone

(501) 663-9415

Fax

(501) 663-1874

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Arkansas Family Care Network

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1336396407
  NPD (past)
• Health Clinic East

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1124168919
  NPD (past)
• Joseph F. Farmer, M.D. P.a., Inc

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1134177272
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1205833738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N UNIVERSITY",
            "address_2": "SUITE 201",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-224-1690",
            "fax_number": "501-224-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 R ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72207",
            "telephone_number": "501-663-9415",
            "fax_number": "501-663-1874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "STEPHEN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C4672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "11217000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "01-20334",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Zareena Khan Tilley, MD
• James Cameron Tilley
• Jett Garrett Tilley, PHARMD
• Kirsten Victoria Tilley
• Lauren Tilley, PA-C
• Zachary Walker Tilley, MD
• Jessica W Tillman
• Robert C Tillman, PT
• Ke'Asia Tilson
• Mary Roz Timbang, M.D.

• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.