Erika Vance Tillery, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH029235 Issued in GA

Practice address

730 N Main St
Cedartown, GA 30125-2358

Phone

(770) 749-5095

Fax

(770) 749-0228

NPI assigned

Jan 23, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Kroger Co

  dba Kroger Drugstore #622

  • Community/Retail Pharmacy
  • Bethlehem, GA
  • NPI 1154294205
  NPD (past)
• The Kroger Co

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Cedartown, GA
  • NPI 1104850940
  NPD (past)

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1487284014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252358",
            "telephone_number": "770-749-5095",
            "fax_number": "770-749-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "ERIKA",
        "middle_name": "VANCE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH029235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF PHARMACY",
            "identifier": "RPH029235",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Sumner, M.ED, CCC-SLP
• Chase Tarleton, LMSW
• The Kroger Co (Kroger Pharmacy)
• Jerry Todd Thompson, DO
• Lauren Thompson, LAT, ATC
• Cherry Lee Tison, APRN
• Ethan Cole Trawick, DC
• Alysia Delaney Treglown, PT, DPT
• Donna Trotter
• Emma Tuck

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.