Gerica Michelle Tillman, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

206282 Issued in LA

Practice address

151 Freestate Blvd
Shreveport, LA 71107-6535

Phone

(318) 226-5990

Fax

(318) 675-0543

NPI assigned

May 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• CBS Act Center LLC

  • Community/Behavioral Health Agency
  • Shreveport, LA
  • NPI 1396081097

  Single Specialty

  NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1730753435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 DECATUR ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116258",
            "telephone_number": "318-347-6653",
            "fax_number": "318-675-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 FREESTATE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076535",
            "telephone_number": "318-226-5990",
            "fax_number": "318-675-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "GERICA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "20180753",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "206282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lensey Wells Tiller, FNP-C
• Megyn Reese Tiller, PHARM.D.
• Charles L Tilley Jr.
• Marimel S. Tilley, O.D.
• Arneka S Tillman, PHARMD
• Sean Andrew Tilmon, MD
• Timeless Care Center LLC
• Alisha Timon, RN
• Timothy W. Angely, D.C., Inc.
• James Tims

• Registered Nurse in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Registered Nurse in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.