Individual provider Active NPI

Amy L. Tillett, N.P.

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1326447780
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24193 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2173
Phone
(423) 778-7000
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28150797A IN
Family Nurse Practitioner 363LF0000X 24193 TN Primary
Family Nurse Practitioner 363LF0000X 71005116A IN

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2173

Mailing address

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 778-7000

Other identifiers 1

IdentifierTypeStateIssuer
Q060856MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20200930003635 TN Practitioner - Nurse Practitioner 4082834486 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28150797AINMDRegistered Nurse
71005116AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation Inc CurrentSince Aug 24, 2020 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Oct 3, 2021 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Oct 3, 2021 Accepting new patients
Memorial Health Partners Foundation, Inc CurrentSince Aug 24, 2020 Accepting new patients
Erlanger Health Past Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Organizations & group practices 7

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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1326447780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032173",
            "telephone_number": "423-778-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032173",
            "telephone_number": "423-778-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLETT",
        "first_name": "AMY",
        "middle_name": "L.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2021-12-08",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28150797A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24193",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005116A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q060856",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.