Active NPI
Marcia Tillman, CRNP
- Acute Care Nurse Practitioner
- Cullman, AL
National Provider Identifier
1669697405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 1-035942
- Practice address
- 1890 Al Highway 157
Suite 300
Cullman, AL 35058-3601 - Phone
- (256) 737-8000
- Fax
- (256) 737-8058
- NPI assigned
- Apr 16, 2007
- 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 |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 1-035942 | AL | Primary |
Addresses
Primary practice location
1890 Al Highway 157
Suite 300
Cullman, AL 35058-3601
Mailing address
1890 Al Highway 157
Suite 300
Cullman, AL 35058-3601
Phone (256) 737-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-035942 | AL | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352419200000",
"number": "1669697405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1890 AL HIGHWAY 157",
"address_2": "SUITE 300",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350583601",
"telephone_number": "256-737-8000",
"fax_number": "256-737-8058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1890 AL HIGHWAY 157",
"address_2": "SUITE 300",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350583601",
"telephone_number": "256-737-8000",
"fax_number": "256-737-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMAN",
"first_name": "MARCIA",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2012-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "AL",
"license": "1-035942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.