James Randolph Tilton Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008948 Issued in MI

Practice address

203 Dilts Rd
Ithaca, MI 48847-9475

Phone

(989) 875-2266

Fax

(989) 875-2225

NPI assigned

Jul 18, 2006

Last updated

Feb 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ithaca Physical Therapy, IncGroup PAC ID 3779879994, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ithaca Physical Therapy, Inc

  • Physical Therapist
  • Ithaca, MI
  • NPI 1316321052
  Medicare reassignment Care Compare group NPD
• James Randolph Tilton

  dba Ithaca Physical Therapy, LLC

  • Physical Therapist
  • Ithaca, MI
  • NPI 1952326753
  Authorized official Same address or phone
• Peak Physical Therapy, Inc.

  • Physical Therapist
  • Saint Louis, MI
  • NPI 1124243621
  NPD (past) Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1720007248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 DILTS RD",
            "city": "ITHACA",
            "state": "MI",
            "postal_code": "488479475",
            "telephone_number": "989-875-2266",
            "fax_number": "989-875-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 DILTS RD",
            "city": "ITHACA",
            "state": "MI",
            "postal_code": "488479475",
            "telephone_number": "989-875-2266",
            "fax_number": "989-875-2225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 W Warwick Dr Unit A",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "MI",
            "postal_code": "488011115",
            "country_code": "US",
            "telephone_number": "989-463-0345",
            "fax_number": "989-466-5472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILTON",
        "first_name": "JAMES",
        "middle_name": "RANDOLPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A2741KD1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM AND BCN",
            "identifier": "650B910270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "64-70128",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE OF WORKERS COMP.",
            "identifier": "607648000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7594704",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "200770947",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Charles Spalding, PHARMD
• Sparrow Carson Hospital (University of Michigan Health-Sparrow)
• Michelle L Spitzley
• Matthew A Stack, PA C
• Michael Andrew Stack, M.D.
• Trauma and Addiction Solutions PLLC
• Shelby Vanscoyoc, LLPC
• Carol A Waters, MA, LPC, CAADC
• William McCarthy, Inc. (Ithaca Pharmacy)
• Hallie J Wilson, DO

• Physical Therapist in Ithaca, MI
• Providers in Ithaca, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.