Mary Tillman

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

083197 Issued in MO

Practice address

1000 E Primrose St
Suite 520
Springfield, MO 65807-5154

Phone

(417) 269-4550

NPI assigned

Aug 8, 2006

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)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

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.

• Lake of the Ozarks Pain Management Services, Inc

  • Specialist
  • Osage Beach, MO
  • NPI 1003901976

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Anesthesia Group of Sarasota PA

  • Anesthesiology Physician
  • Sarasota, FL
  • NPI 1063471514
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679583181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST",
            "address_2": "SUITE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075154",
            "telephone_number": "417-269-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PRIMROSE ST",
            "address_2": "SUITE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075154",
            "telephone_number": "417-269-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "083197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty Gail Tilleman, ATC, LAT
• Bryce Tilley
• David Paul Tillman, D.O.
• Julian Scott Tillman, MA, LPC
• Kerri Elise Tillman, MS PLPC NCC
• Samuel Joseph Tillman, AU.D.
• Nicholas Storm Timmerwilke, MD
• Dana Tindell, RD, LD, CDE
• Matthew H. Ting, M.D.
• Sabrina Tinker

• All providers in Springfield, MO
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.