Active NPI
David Tiller, MD
- Forensic Psychiatry Physician
- Spencer, OK
National Provider Identifier
1336155373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychiatry Physician
- License
- 26522
- Practice address
- 2601 Spencer Rd
Spencer, OK 73084-3649 - Phone
- (405) 427-2441
- Fax
- (405) 427-4741
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | 26522 | OK | Primary |
Addresses
Primary practice location
2601 Spencer Rd
Spencer, OK 73084-3649
Mailing address
5300 N Independence Ave
Suite 280
Oklahoma City, OK 73112-5556
Phone (405) 427-2441
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDG232 | Other | PREFERRED CARE | |
| P010204490 | Other | BLUE CHOICE | |
| P00115455 | Other | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Wayne | Past | Accepting new patients | |
| The Frederick Ferris Thompson Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lyons, NY
- NPI 1003824855
-
dba UR Medicine Thompson Health Victor Medical Group Pharmacy
- Community/Retail Pharmacy
- Victor, NY
- NPI 1831914274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1336155373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 N INDEPENDENCE AVE",
"address_2": "SUITE 280",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731125556",
"telephone_number": "405-427-2441",
"fax_number": "405-427-4741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 SPENCER RD",
"city": "SPENCER",
"state": "OK",
"postal_code": "730843649",
"telephone_number": "405-427-2441",
"fax_number": "405-427-4741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLER",
"first_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "OK",
"license": "26522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "MDG232",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "P010204490",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00115455",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Spencer, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.