Active NPI
Terrance Tillison
- Case Manager/Care Coordinator
- Oxon Hill, MD
National Provider Identifier
1225733553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1100 Kennebec St Apt 4D
Oxon Hill, MD 20745-3308 - Phone
- (202) 880-4987
- NPI assigned
- Apr 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1100 Kennebec St Apt 4D
Oxon Hill, MD 20745-3308
Mailing address
1100 Kennebec St Apt 4D
Oxon Hill, MD 20745-3308
Phone (202) 880-4987
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
708 Main St
FL 10
Houston, TX 77002-0001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anchor 180 LLC | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Case Management Agency
- Houston, TX
- NPI 1780472027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1225733553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 KENNEBEC ST APT 4D",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207453308",
"telephone_number": "202-880-4987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 KENNEBEC ST APT 4D",
"city": "OXON HILL",
"state": "MD",
"postal_code": "207453308",
"telephone_number": "202-880-4987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLISON",
"first_name": "TERRANCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-04",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxon Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.