Rosemary Tilmon-Kellum, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

13327 Issued in CA

Practice address

1250 Bellflower Blvd.
Student Health Center
Long Beach, CA 90840

Phone

(562) 985-4771

Fax

(562) 985-1644

NPI assigned

Dec 12, 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

Other names 1

• Mrs. Rosemary Kellum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1710047220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BELLFLOWER BLVD",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90840",
            "telephone_number": "562-985-4771",
            "fax_number": "562-985-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BELLFLOWER BLVD.",
            "address_2": "STUDENT HEALTH CENTER",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90840",
            "telephone_number": "562-985-4771",
            "fax_number": "562-985-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILMON-KELLUM",
        "first_name": "ROSEMARY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "13327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEMARY",
            "last_name": "KELLUM",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sarah Elizabeth Tidwell
• Alicia Tiedra
• Shawn Patrick Tierney, D.C.
• Dorianne Tillano, NP- C
• Dion Lee Tillman
• Penny R Timmen, LCSW
• Jennifer Timmons
• Latoya Timmons
• Michael Anthony Timonian, MD
• Lisa Marie Tinch, RN

• Medical Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.