Samantha An Tilley, MS, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2025028595 Issued in MO

Practice address

1161 Fortune Blvd Ste 200
Shiloh, IL 62269-7385

Phone

(314) 804-1848

NPI assigned

Aug 4, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Branz Nutrition Counseling

  • Registered Dietitian
  • O'Fallon, IL
  • NPI 1225785561

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1679457469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9089 NORTH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631144063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 FORTUNE BLVD STE 200",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697385",
            "telephone_number": "314-804-1848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10525 Big Bend Rd",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631226227",
            "country_code": "US",
            "telephone_number": "314-804-1848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "SAMANTHA",
        "middle_name": "AN",
        "name_prefix": "Ms.",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2025028595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Laura Steiner, MD
• Dustin Storck, D.P.T.
• Kyla Gelina Sulcer, PTA
• Umar Tariq, M.D.
• The Rehabilitation Institute of Southern Illinois,LLC (The Rehabilitation Institute of Southern Illinois)
• Total Renal Care Inc (O'Fallon Dialysis)
• Sydnie Elizabeth Twillmann, PHARMD
• John L Visconti, DO
• Diana Leigh Vork
• Sheila Forrest Wagner, OTR/L

• Registered Dietitian in Shiloh, IL
• Providers in Shiloh, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.