Kristin Till

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

206061 Issued in AK

Practice address

1600 Glacier Ave
Juneau, AK 99801-1430

Phone

(907) 586-1542

NPI assigned

Aug 15, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/766713c8-6704-4cf2-bcff-6dfc96f148b0/

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.

• Glacier Pediatrics, LLC

  • Primary Care Clinic/Center
  • Juneau, AK
  • NPI 1558500694
  NPD (past)

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1356124143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 GLACIER AVE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011430",
            "telephone_number": "907-586-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GLACIER AVE",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011430",
            "telephone_number": "907-586-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "206061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredrik Thorsteinson
• Nicole Marie Tice
• Tides LLC
• Jack Peter Tiemessen, BHA
• Maria Tijerina-Burleson, D.C.
• Angela Tilleson
• Brent Jonathan Tingey, DMD
• Mark S Tinneny
• David To, LMT
• Michael W Tobin, MD

• Physician Assistant in Juneau, AK
• Providers in Juneau, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.