Ashley Nicole Tiller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3826 Issued in SC

Practice address

3109 Casey St
Loris, SC 29569-2807

Phone

(843) 756-9292

Fax

(843) 756-9260

NPI assigned

May 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Conway Home health agency, Conway, SC, CCN 427112
• Well Care Home Health of the Lowcountry Inc Home health agency, Myrtle Beach, SC, CCN 427138
• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atiller19443@directmcleodehealth.org

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.

• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494
  Medicare reassignment Care Compare group
• SC House Calls Inc

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1518048859
  Medicare reassignment NPD
• McLeod Physician Associates II

  • Urgent Care Clinic/Center
  • Florence, SC
  • NPI 1104035492
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Home Health of South Carolina LLC

  • Home Health Agency
  • Conway, SC
  • NPI 1316905573
  Care Compare affiliation
• McLeod Loris Seacoast Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation
• Well Care Home Health of the Lowcountry

  • Home Health Agency
  • Myrtle Beach, SC
  • NPI 1124536446
  Care Compare affiliation

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1700451499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-756-9292",
            "fax_number": "843-756-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 CASEY ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692807",
            "telephone_number": "843-756-9292",
            "fax_number": "843-756-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3826",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4646PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Loris, SC
• Providers in Loris, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.