Kim L Tillery, PHD

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

0014251 Issued in NY

Practice address

280 Central Ave
Suny at Fredonia
Fredonia, NY 14063-1127

Phone

(716) 673-3203

Fax

(716) 673-3235

NPI assigned

Jan 31, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467599159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CENTRAL AVE",
            "address_2": "SUNY AT FREDONIA",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631127",
            "telephone_number": "716-673-3203",
            "fax_number": "716-673-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 CENTRAL AVE",
            "address_2": "SUNY AT FREDONIA",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631127",
            "telephone_number": "716-673-3203",
            "fax_number": "716-673-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "KIM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NY",
            "license": "0014251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Ihrig, OD
• Jillian Lindsay Stonefoot, MS
• Natalie Swanson, O.D.
• Phillip F. Terrano, L.C.S.W.-R
• Danielle Marie Thompson
• Sarah Christine Titus, LCSW
• Twichell and Lukasik DDS
• Mark L Twichell, DDS
• Kathryn Marie Vanvalkenburg, PHARM-D
• Sandra Vedovato, PH.D.

• Audiologist-Hearing Aid Fitter in Fredonia, NY
• Providers in Fredonia, NY by specialty
• Audiologist-Hearing Aid Fitter in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.