Hephzibah Ebony Tillery, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9357098 Issued in FL

Practice address

7901 4TH St N Ste 11488
Saint Petersburg, FL 33702-4305

Phone

(813) 328-2779

NPI assigned

Oct 30, 2017

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

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1528570520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 11488",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "813-328-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 11488",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "813-328-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "HEPHZIBAH",
        "middle_name": "EBONY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2023-04-06",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9357098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Anne Tiehaara, CRNA
• Jessica Lee Tieman, RN
• Mallory Tiffany, LMHC, LPC
• Sydney Tiiman
• Tikvah Counseling, LLC
• Ariana Tilley
• Jordyn E Tilman, M.A.
• Delinda D Tim, APRN
• Iyanna Tim, RN
• Patricia Kay Timmerman, OTR

• Family Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.