Active NPI
Kenneth G Tilghman, M.D.
- Pediatrics Physician
- Richmond, VA
National Provider Identifier
1437178282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101054150
- Practice address
- 10442 Midlothian Tpke
Richmond, VA 23235-4408 - Phone
- (804) 560-9240
- Fax
- (804) 560-9242
- NPI assigned
- Jul 19, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101054150 | VA | Primary |
Addresses
Primary practice location
10442 Midlothian Tpke
Richmond, VA 23235-4408
Mailing address
4107 Tweedsmuir Rd
Moseley, VA 23120-1290
Phone (804) 639-5106
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061663496 | Other | VA | TRICARE |
| 462448 | Other | VA | ANTHEM |
| 6738125 | Medicaid | VA | |
| 129450 | Other | VA | AETNA |
| 13733 | Other | VA | SENTARA OPTIMA |
| 8100327 | Other | VA | MAMSI UNITEDHEALTHCARE |
| 202874 | Other | VA | SOUTHERN HEALTH |
| 40340 | Other | VA | CARENET |
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 |
|---|---|---|---|
| 0101054150 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374537600000",
"number": "1437178282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4107 TWEEDSMUIR RD",
"city": "MOSELEY",
"state": "VA",
"postal_code": "231201290",
"telephone_number": "804-639-5106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10442 MIDLOTHIAN TPKE",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232354408",
"telephone_number": "804-560-9240",
"fax_number": "804-560-9242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILGHMAN",
"first_name": "KENNETH",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2013-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101054150",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "061663496",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "462448",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6738125",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "129450",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA OPTIMA",
"identifier": "13733",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI UNITEDHEALTHCARE",
"identifier": "8100327",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "202874",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARENET",
"identifier": "40340",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.