Active NPI
Laura L Tilley
- Behavior Technician
- Rincon, GA
National Provider Identifier
1598577009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 800 Towne Park Dr Ste 200
Rincon, GA 31326-5158 - Phone
- (912) 556-0101
- NPI assigned
- Jan 22, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
800 Towne Park Dr Ste 200
Rincon, GA 31326-5158
Mailing address
800 Towne Park Dr Ste 200
Rincon, GA 31326-5158
Phone (912) 556-0101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110026265E | Medicaid | MA |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1598577009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 TOWNE PARK DR STE 200",
"city": "RINCON",
"state": "GA",
"postal_code": "313265158",
"telephone_number": "912-556-0101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 TOWNE PARK DR STE 200",
"city": "RINCON",
"state": "GA",
"postal_code": "313265158",
"telephone_number": "912-556-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "LAURA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-22",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110026265E",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rincon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.