Active NPI
Katy Tilley
- Family Nurse Practitioner
- Vonore, TN
National Provider Identifier
1457712424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 20895
- Practice address
- 1206 Highway 411
Vonore, TN 37885-2455 - Phone
- (423) 884-7271
- Fax
- (423) 884-3277
- NPI assigned
- Mar 17, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 20895 | TN | Primary |
Addresses
Primary practice location
1206 Highway 411
Vonore, TN 37885-2455
Mailing address
PO Box 278
Madisonville, TN 37354-0278
Phone (423) 442-2622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20895 | Other | TN | STATE LICENSE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458172800000",
"number": "1457712424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 278",
"city": "MADISONVILLE",
"state": "TN",
"postal_code": "373540278",
"telephone_number": "423-442-2622",
"fax_number": "423-442-5760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1206 HIGHWAY 411",
"city": "VONORE",
"state": "TN",
"postal_code": "378852455",
"telephone_number": "423-884-7271",
"fax_number": "423-884-3277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "KATY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-17",
"last_updated": "2016-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "20895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "20895",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vonore, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.