Jacqueline Antoinette Tiller, MSN,FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0000558 Issued in DE

Practice address

810 New Burton Rd
Suite #1
Dover, DE 19904-5488

Phone

(302) 744-9310

Fax

(302) 744-9312

NPI assigned

Jun 7, 2011

Sex

Female

Sole proprietor

Yes

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 DE

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology Associates PAGroup PAC ID 9830098177, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

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.

• Nephrology Associates PA

  • Nephrology Physician
  • Newark, DE
  • NPI 1407805203
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1386938249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 NEW BURTON RD",
            "address_2": "SUITE #1",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199045488",
            "telephone_number": "302-744-9310",
            "fax_number": "302-744-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NEW BURTON RD",
            "address_2": "SUITE #1",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199045488",
            "telephone_number": "302-744-9310",
            "fax_number": "302-744-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "JACQUELINE",
        "middle_name": "ANTOINETTE",
        "credential": "MSN,FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Thorogood, MD
• Michelle Thorpe, HIS
• Tideforge Health
• Tessa Tierson, LCSW
• Cecilia Till
• Ashley Hannah Tillman, PHARMD
• Donald Clarke Tilton, D.O.
• Time & Patience Consulting, LLC
• Lauren Elizabeth Tinsley, L.P.C.M.H., RPT-S
• TLD Worldwide LLC

• Family Nurse Practitioner in Dover, DE
• Providers in Dover, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.