Active NPI
John L Tilley, PSY.D.
- Clinical Psychologist
- Columbus, OH
National Provider Identifier
1578640363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5865
- Practice address
- 20 South Third Street
Suite 210
Columbus, OH 43215 - Phone
- (614) 325-5970
- NPI assigned
- Nov 1, 2006
- Last updated
- Nov 6, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5865 | OH | Primary |
Addresses
Primary practice location
20 South Third Street
Suite 210
Columbus, OH 43215
Mailing address
20 South Third Street
Suite 210
Columbus, OH 43215
Phone (614) 325-5970
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446768000000",
"number": "1578640363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 SOUTH THIRD STREET",
"address_2": "SUITE 210",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43215",
"telephone_number": "614-325-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 SOUTH THIRD STREET",
"address_2": "SUITE 210",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43215",
"telephone_number": "614-325-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "JOHN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2015-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.