Crystal Tillery, MSN, APRN, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

33320 Issued in TN

Practice address

979 E 3Rd St Ste C830
Chattanooga, TN 37403-3325

Phone

(423) 778-9001

Fax

(423) 778-4692

NPI assigned

Dec 20, 2023

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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.

• Erlanger Health

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1477256303
  Medicare reassignment NPD
• Erlanger Health

  • Durable Medical Equipment & Medical Supplies
  • Chattanooga, TN
  • NPI 1740073329
  NPD

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1750150629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE C830",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374033325",
            "telephone_number": "423-778-9001",
            "fax_number": "423-778-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE C830",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374033325",
            "telephone_number": "423-778-9001",
            "fax_number": "423-778-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "CRYSTAL",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "33320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Margaret Tickle
• Tiffany Hayes, PA
• Frank Tift, M.D.
• Michael C Tigar, MD
• Tasha Tigner
• Amy L. Tillett, N.P.
• Anthony G Tillman
• Time for Ketamine LLC
• Time Treatment Center LLC
• Time Wellness Treatment Resources LLC

• Acute Care Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.