Active NPI
Lynn Marie Tillman
- Optician
- Auburn, CA
National Provider Identifier
1326105057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- D6922
- Practice address
- 2188 Grass Valley Hwy
Auburn, CA 95603-2522 - Phone
- (530) 889-9985
- NPI assigned
- Jan 2, 2007
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | D6922 | CA | Primary |
Addresses
Primary practice location
2188 Grass Valley Hwy
Auburn, CA 95603-2522
Mailing address
6456 Pinehaven Rd
Oakland, CA 94611-1246
Phone (510) 339-6256
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 |
|---|---|---|---|
| D6922 | CA | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LMT 4U Inc. | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326105057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6456 PINEHAVEN RD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946111246",
"telephone_number": "510-339-6256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2188 GRASS VALLEY HWY",
"city": "AUBURN",
"state": "CA",
"postal_code": "956032522",
"telephone_number": "530-889-9985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "LYNN",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "CA",
"license": "D6922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.