Carrie S Tilley, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN-1005956 Issued in DC

Practice address

2150 Pennsylvania Ave NW
Suite 1-200
Washington, DC 20037-3201

Phone

(202) 741-2478

Fax

(202) 741-2487

NPI assigned

Jun 25, 2009

Last updated

Jul 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carrie.tilley.1@30057.direct.athenahealth.com
• Direct secure messaging: carrie.tilley.1@33357.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CT Preventive Health Edge Medical PC

  • General Practice Physician
  • Stamford, CT
  • NPI 1972394773
  NPD (past)
• Ny Proactive Medicine PC

  • General Practice Physician
  • New York, NY
  • NPI 1235920372
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1467680785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "address_2": "SUITE 1-200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-741-2478",
            "fax_number": "202-741-2487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "address_2": "SUITE 1-200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "202-741-2478",
            "fax_number": "202-741-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "CARRIE",
        "middle_name": "S",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN-1005956",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R175392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mili A Tilahun
• Rakeb A Tilahun, DDS
• Carrelle Shaffer Tiller, LICSW
• Julia Tiller, BCBA
• Dawn Tillery
• Laura Cookman Tilley, MD
• Allen Tillman
• Ashley Keyona Tillman
• Christina Tillman
• Shaquita Tillman, LGPC

• Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.