Fanny Almeydi Rivera Tiller

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP141418 Issued in TX

Practice address

620 Round Rock West Dr
Round Rock, TX 78681-5086

Phone

(512) 827-7422

NPI assigned

May 5, 2019

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

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fanny.tiller.1@8363.direct.athenahealth.com
• Direct secure messaging: fanny.tiller.1@13711.direct.athenahealth.com

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.

• VMD Primary Providers of South Central Texas PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1790318566
  Medicare reassignment NPD
• Pair Team Medical Group, P.a.

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1659132553

  TX

  Medicare reassignment NPD
• Global Wound Care Medical Group

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1235831132
  NPD
• Pair Team Medical Group of California PC

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1134838352
  NPD

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

{
    "created_epoch": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557014400000",
    "number": "1376108464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 RYDEN ST",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786539775",
            "telephone_number": "512-906-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ROUND ROCK WEST DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815086",
            "telephone_number": "512-827-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "FANNY",
        "middle_name": "ALMEYDI RIVERA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2019-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kira Anlyn Thurston
• Lorie Tibbits, LVN, RN
• Matthew Shane Tibbits, LVN
• Jameson Tieman, MD
• Tier 3 Montessori
• Eden Denyse Tilley
• Tim Robins M.D.,P.a.
• Time Mental Health, LLC
• Kelly Timmons
• Tina J. Philip, D.O. PLLC

• Family Nurse Practitioner in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.