Katherine Tillman

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906834 Issued in FL

Practice address

8119 N Mulberry St
Tampa, FL 33604-3443

Phone

(813) 410-6159

NPI assigned

Jan 11, 2016

Last updated

Jan 27, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1689030330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8119 N MULBERRY ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336043443",
            "telephone_number": "813-410-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8119 N MULBERRY ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336043443",
            "telephone_number": "813-410-6159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12811 N Nebraska Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336124401",
            "country_code": "US",
            "telephone_number": "813-410-6159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "CL1189677",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheridan Tihista
• Elizabeth Ann Tilka, D.C.
• Jennifer Darlene Tiller, MD
• Jenna Leigh Tillett, APRN
• Chenette Tillman
• Quankela Tillman
• Tywaun Kretrica Tillman, MD
• Jacquelyn Tillwick, MSW
• Shelbie Timlake
• Lia Timmel

• Adult Care Home Facility in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.