Individual provider Active NPI

Dennis Dean Tillotson, DC

  • Chiropractor
  • Victoria, TX
National Provider Identifier
1700977527
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4615 Issued in TX
Practice address
101 North Park Dr
Victoria, TX 77901-2924
Phone
(361) 576-4325
Fax
(361) 576-9793
NPI assigned
Sep 27, 2006
Last updated
Dec 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4615 TX Primary

Addresses

Primary practice location

101 North Park Dr
Victoria, TX 77901-2924

Mailing address

101 North Park Dr
Victoria, TX 77901-2924
Phone (361) 576-4325

Other identifiers 1

IdentifierTypeStateIssuer
C06018631MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000424 TX Practitioner - Chiropractic 1355539263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1304 E Rio Grande St
A
Victoria, TX 77901-6241
Phone (361) 576-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4615TXMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis D Tillotson DC LLC Chiropractor CurrentSince Sep 1, 2021 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

1304 E Rio Grande St
#A
Victoria, TX 77901
Phone (361) 576-4325

5005 John Stockbauer Dr
Ste B
Victoria, TX 77904
Phone (361) 576-4325

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1700977527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NORTH PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012924",
            "telephone_number": "361-576-4325",
            "fax_number": "361-576-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NORTH PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012924",
            "telephone_number": "361-576-4325",
            "fax_number": "361-576-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "DENNIS",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C06018631",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.