Active NPI
Kendra Lea Tilley, RPSGT
- Other Technician
- Cheyenne, WY
National Provider Identifier
1619480621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 12910
- Practice address
- 2360 E Pershing Blvd
Cheyenne, WY 82001-5356 - Phone
- (307) 778-7550
- NPI assigned
- Nov 13, 2017
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 12910 | Primary |
Addresses
Primary practice location
2360 E Pershing Blvd
Cheyenne, WY 82001-5356
Mailing address
1733 Globe CT
Fort Collins, CO 80528-6205
Phone (316) 737-1373
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": "1510531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510531200000",
"number": "1619480621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 GLOBE CT",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805286205",
"telephone_number": "316-737-1373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 E PERSHING BLVD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820015356",
"telephone_number": "307-778-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "KENDRA",
"middle_name": "LEA",
"credential": "RPSGT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-13",
"last_updated": "2017-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": "12910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.