Austin Dale Tiller, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

7400 Lynn Ave
Hamlin, WV 25523-1138

Phone

(304) 824-5806

Fax

(304) 824-5804

NPI assigned

Nov 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lincoln County Primary Care Center IncGroup PAC ID 6204821879, shared by 25 NPIs, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: austin.tiller.1@6401.direct.athenahealth.com

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.

• Lincoln County Primary Care Center Inc

  dba Southern West Virginia Health System-Whitesville

  • Federally Qualified Health Center (FQHC)
  • Whitesville, WV
  • NPI 1528768322
  Medicare reassignment NPD
• Lincoln County Primary Care Center Inc

  dba Southern West Virginia Health System-Madison Medical

  • Federally Qualified Health Center (FQHC)
  • Madison, WV
  • NPI 1720586472
  Medicare reassignment NPD
• Lincoln County Primary Care Center Inc

  dba Southern West Virginia Health System-Wharton

  • Federally Qualified Health Center (FQHC)
  • Wharton, WV
  • NPI 1821790692
  Medicare reassignment NPD
• Lincoln County Primary Care Center Inc

  dba Southern West Virginia Health System-Oceana

  • Federally Qualified Health Center (FQHC)
  • Oceana, WV
  • NPI 1912609785
  Medicare reassignment NPD
• Lincoln County Primary Care Center, Inc.

  dba Southern West Virginia Health System-

  • Federally Qualified Health Center (FQHC)
  • South Charleston, WV
  • NPI 1457610594
  Medicare reassignment NPD
• Lincoln County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hamlin, WV
  • NPI 1942274543
  Medicare reassignment NPD
• Hygeia Facilities Foundation Inc

  dba Raleigh Boone Medical Center

  • Federally Qualified Health Center (FQHC)
  • Whitesville, WV
  • NPI 1467512152
  NPD
• Lincoln County Primary Care Center, Inc

  dba Southern West Virgina Health System-Logan

  • Federally Qualified Health Center (FQHC)
  • Logan, WV
  • NPI 1023331220
  NPD
• Lincoln County Primary Care Center, Inc

  dba Salt Rock Medical Center

  • Federally Qualified Health Center (FQHC)
  • Salt Rock, WV
  • NPI 1942509856
  NPD
• Lincoln County Primary Care Center, Inc.

  dba Southern West Virginia Health System-Delbarton

  • Federally Qualified Health Center (FQHC)
  • Delbarton, WV
  • NPI 1033490149
  NPD
• Lincoln County Primary Care Center, Inc.

  dba Guyan Valley Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Branchland, WV
  • NPI 1255521027
  NPD
• Lincoln County Primary Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Man, WV
  • NPI 1689997678
  NPD

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

{
    "created_epoch": "1573948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1235774910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 LYNN AVE",
            "city": "HAMLIN",
            "state": "WV",
            "postal_code": "255231138",
            "telephone_number": "304-824-5806",
            "fax_number": "304-824-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 LYNN AVE",
            "city": "HAMLIN",
            "state": "WV",
            "postal_code": "255231138",
            "telephone_number": "304-824-5806",
            "fax_number": "304-824-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "AUSTIN",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-17",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Terry
• Katrina Thacker
• Kristen Marie Thompson-Blanks
• Deanna Thompson
• Kaleb Andrew Thompson
• Alexander F Todd, PHARMD
• Frances Tomblin
• Cherish Toney
• Jessica Toney
• Natosha Toney

• Medical Physician Assistant in Hamlin, WV
• Providers in Hamlin, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.

Verify at the official NPI Registry.