Active NPI
Keith Tilley, RPH
- Pharmacist
- Shawnee, OK
National Provider Identifier
1609158898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11790
- Practice address
- 1427 N Harrison St
Shawnee, OK 74801-5245 - Phone
- (405) 273-8520
- Fax
- (405) 273-0542
- NPI assigned
- Sep 13, 2011
- Last updated
- Sep 13, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11790 | OK | Primary |
Addresses
Primary practice location
1427 N Harrison St
Shawnee, OK 74801-5245
Mailing address
1427 N Harrison
Shawnee, OK 74801
Phone (405) 390-8741
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
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1609158898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1427 N HARRISON",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "74801",
"telephone_number": "405-390-8741",
"fax_number": "405-273-0542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1427 N HARRISON ST",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748015245",
"telephone_number": "405-273-8520",
"fax_number": "405-273-0542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "KEITH",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "11790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.