Active NPI
Janice Nicole Tillmon
- Social Worker
- Detroit, MI
National Provider Identifier
1750912416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801099132
- Practice address
- 7800 W Outer Dr Ste 300
Detroit, MI 48235-3458 - Phone
- (313) 283-5135
- NPI assigned
- Jan 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801099132 | MI | Primary |
Addresses
Primary practice location
7800 W Outer Dr Ste 300
Detroit, MI 48235-3458
Mailing address
20547 Murray Hill St
Detroit, MI 48235-2132
Phone (313) 283-5135
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | janice.tillmon@ymail.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801099132 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1750912416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20547 MURRAY HILL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482352132",
"telephone_number": "313-283-5135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7800 W OUTER DR STE 300",
"city": "DETROIT",
"state": "MI",
"postal_code": "482353458",
"telephone_number": "313-283-5135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLMON",
"first_name": "JANICE",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-31",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801099132",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "janice.tillmon@ymail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "7800 W Outer Dr Ste 300",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482353458",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.