Active NPI
Jan L Tilley, RD, LD
- Registered Dietitian
- San Antonio, TX
National Provider Identifier
1649446360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT04462
- Practice address
- 400 N Loop 1604 E
Suite 175
San Antonio, TX 78232-1258 - Phone
- (210) 545-4422
- Fax
- (210) 545-4495
- NPI assigned
- May 2, 2008
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT04462 | TX | Primary |
Addresses
Primary practice location
400 N Loop 1604 E
Suite 175
San Antonio, TX 78232-1258
Mailing address
30063 Cloud View Dr
Bulverde, TX 78163-4031
Phone (210) 545-4422
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1649446360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30063 CLOUD VIEW DR",
"city": "BULVERDE",
"state": "TX",
"postal_code": "781634031",
"telephone_number": "210-545-4422",
"fax_number": "210-545-4495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N LOOP 1604 E",
"address_2": "SUITE 175",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782321258",
"telephone_number": "210-545-4422",
"fax_number": "210-545-4495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "JAN",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-02",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT04462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.