Individual provider Active NPI

Tamara Till, FNP-BC

  • Family Nurse Practitioner
  • Orangeburg, SC
National Provider Identifier
1619504248
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23808 Issued in SC
Practice address
1324 Grove Park Dr
Orangeburg, SC 29115-2455
Phone
(803) 536-0007
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23808 SC Primary

Addresses

Primary practice location

1324 Grove Park Dr
Orangeburg, SC 29115-2455

Mailing address

196 Big Buck Blvd
Orangeburg, SC 29115-9516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200520001697 SC Practitioner - Nurse Practitioner 5799116018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Orange Cut Rate Drug Store, Inc.Group PAC ID 4385704865, 2 clinicians

Practice addresses (Care Compare)

1326 Grove Park Dr
Orangeburg, SC 29115-2455
Phone (803) 888-2600

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orange Cut Rate Drug Store, Inc. CurrentSince Apr 16, 2020 Accepting new patients
Orange Cut Rate Drug Store, Inc CurrentSince Apr 16, 2020 Accepting new patients

Locations

1326 Grove Park Dr
Orangeburg, SC 29115
Phone (803) 536-0007

1324 Grove Park Dr
Orangeburg, SC 29115
Phone (803) 534-1164

Interoperability endpoints

  • Direct secure messaging: tamara.till.1@18835.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1619504248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 BIG BUCK BLVD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291159516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 GROVE PARK DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291152455",
            "telephone_number": "803-536-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "TAMARA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.