Active NPI
David Tillema, M.D...
- Orthopaedic Surgery Physician
- Lake Lotawana, MO
National Provider Identifier
1396174033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 2004002777
- Practice address
- 9 K St
Lake Lotawana, MO 64086-9439 - Phone
- (816) 578-4335
- NPI assigned
- Nov 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2004002777 | MO | Primary |
Addresses
Primary practice location
9 K St
Lake Lotawana, MO 64086-9439
Mailing address
9 K St
Lake Lotawana, MO 64086-9439
Phone (816) 578-4335
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2004002777 | MO | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockhill Orthopaedics Inc | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Lees Summit, MO
- NPI 1851352140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383523200000",
"number": "1396174033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 K ST",
"city": "LAKE LOTAWANA",
"state": "MO",
"postal_code": "640869439",
"telephone_number": "816-578-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 K ST",
"city": "LAKE LOTAWANA",
"state": "MO",
"postal_code": "640869439",
"telephone_number": "816-578-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEMA",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D...",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-04",
"last_updated": "2013-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "2004002777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Lotawana, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.