Jacqueline Tillery

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Practice address

9441 Kylie Cir
Anchorage, AK 99502-1448

Phone

(919) 808-7163

NPI assigned

Mar 10, 2022

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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.

• Doves at Marquis LLC

  • Assisted Living Facility
  • Anchorage, AK
  • NPI 1033854294
  NPD Authorized official

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1578211496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9441 KYLIE CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995021448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 KYLIE CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995021448",
            "telephone_number": "919-808-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Martin Tieva, M.D.
• Martin Herbert Tieva, MD
• Anita Tigert, ANP
• Yvonne Tijerina-Burleson, DDS
• Tikishla Medical Massage
• Zoe Tillotson
• Time for Speech Therapy
• Rosemary Timmerman, DNP, APRN, CCNS
• James Kyle Timmons, PH.D.
• Tanyka Nicole Timmons

• Assisted Living Facility in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.