Active NPI
Brittany J Tillman
- Marriage & Family Therapist
- Cary, NC
National Provider Identifier
1245605187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1818
- Practice address
- 103 Fountain Brook Circle
Suite D-3
Cary, NC 27511 - Phone
- (919) 694-7128
- Fax
- (919) 234-5117
- NPI assigned
- Dec 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 10061A | NC | |
| Marriage & Family Therapist | 106H00000X | 1818 | NC | Primary |
Addresses
Primary practice location
103 Fountain Brook Circle
Suite D-3
Cary, NC 27511
Mailing address
1423 Old Buckhorn Rd
Garner, NC 27529-3770
Phone (910) 650-9603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 8, 2024 through Jan 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10061A | NC | MD | Marriage & Family Therapist |
| 1818 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1245605187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1423 OLD BUCKHORN RD",
"city": "GARNER",
"state": "NC",
"postal_code": "275293770",
"telephone_number": "910-650-9603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 FOUNTAIN BROOK CIRCLE",
"address_2": "SUITE D-3",
"city": "CARY",
"state": "NC",
"postal_code": "27511",
"telephone_number": "919-694-7128",
"fax_number": "919-234-5117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "BRITTANY",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-03",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "10061A",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.