Active NPI
Cynthia Joiner Tillman, FNP
- Family Nurse Practitioner
- Gretna, LA
National Provider Identifier
1558630236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP06704
- Practice address
- 501 Lapalco Blvd
Jencare Neighborhood Medical Center WB, LLC
Gretna, LA 70056 - Phone
- (504) 393-4376
- Fax
- (504) 393-4381
- NPI assigned
- Dec 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | AP06704 | LA | Primary |
Addresses
Primary practice location
501 Lapalco Blvd
Jencare Neighborhood Medical Center WB, LLC
Gretna, LA 70056
Mailing address
501 Lapalco Blvd
Jencare Neighborhood Medical Center WB, LLC
Gretna, LA 70056
Phone (504) 393-4376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4710 Oneal LN
Suite 112
Baton Rouge, LA 70817-1623
Phone (225) 926-7200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1144522855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1558630236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 LAPALCO BLVD",
"address_2": "JENCARE NEIGHBORHOOD MEDICAL CENTER WB, LLC",
"city": "GRETNA",
"state": "LA",
"postal_code": "70056",
"telephone_number": "504-393-4376",
"fax_number": "504-393-4381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 LAPALCO BLVD",
"address_2": "JENCARE NEIGHBORHOOD MEDICAL CENTER WB, LLC",
"city": "GRETNA",
"state": "LA",
"postal_code": "70056",
"telephone_number": "504-393-4376",
"fax_number": "504-393-4381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "CYNTHIA",
"middle_name": "JOINER",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-23",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "AP06704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gretna, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.