Individual provider Active NPI

Patricia Marie Tilleman, RN

  • Ambulatory Care Registered Nurse
  • Box Elder, MT
National Provider Identifier
1720258908
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
12815 Issued in MT
Practice address
RR 1 Box 664
Box Elder, MT 59521-9797
Phone
(406) 395-4486
Fax
(406) 395-5850
NPI assigned
Mar 4, 2008
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 12815 MT Primary

Addresses

Primary practice location

RR 1 Box 664
Box Elder, MT 59521-9797

Mailing address

RR 1 Box 664
Box Elder, MT 59521-9797
Phone (406) 395-4486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
12815MTMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1720258908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 664",
            "city": "BOX ELDER",
            "state": "MT",
            "postal_code": "595219797",
            "telephone_number": "406-395-4486",
            "fax_number": "406-395-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 664",
            "city": "BOX ELDER",
            "state": "MT",
            "postal_code": "595219797",
            "telephone_number": "406-395-4486",
            "fax_number": "406-395-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEMAN",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MT",
            "license": "12815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Box Elder, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.