Kimberly Tillman

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN.143666M-IV Issued in OH

Practice address

11410 Ashbury Ave
Cleveland, OH 44106

Phone

(216) 246-8014

NPI assigned

Jul 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Kimberly L Tillman

  • Licensed Practical Nurse
  • Cleveland, OH
  • NPI 1881000461
  NPD (past) Authorized official

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1679989172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 ASHBURY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-246-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 ASHBURY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44106",
            "telephone_number": "216-246-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.143666M-IV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PN.143666-M-IV",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Tillett, CPNP-PC
• Lavada Tillie, MSN, FNP-C, CNP
• Denice C Tillman
• Desmond Mario Tillman, RN
• Dontez Tillman, LMT
• Sharon Tillman, LPN
• Emma Tilow, APRN.CNP
• Thipwimol Tim-Aroon, M.D.
• Jennifer Lynn Timan-Roman, RN
• Alisa Timashpolsky, M.D.

• Licensed Practical Nurse in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.