Sandy Tillery

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

2203781168 Issued in LA

Practice address

200 Joe Johnson Rd
Holden, LA 70744-8006

Phone

(225) 777-4204

Fax

(225) 777-4205

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Quality Community Homes LLC

  • In Home Supportive Care Agency
  • Holden, LA
  • NPI 1467792416
  NPD (past) Authorized official
• Quality Community Homes LLC

  • In Home Supportive Care Agency
  • Holden, LA
  • NPI 1952641516
  NPD (past) Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1770827818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JOE JOHNSON RD",
            "city": "HOLDEN",
            "state": "LA",
            "postal_code": "707448006",
            "telephone_number": "225-777-4204",
            "fax_number": "225-777-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOE JOHNSON RD",
            "city": "HOLDEN",
            "state": "LA",
            "postal_code": "707448006",
            "telephone_number": "225-777-4204",
            "fax_number": "225-777-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "SANDY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "LA",
            "license": "2203781168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary Care Providers for a Healthy Feliciana, Inc (RKM at Holden)
• Quality Community Homes LLC
• Quality Community Homes LLC
• Christina Marie Seal, PHARM D
• Andie Street
• Valerie Dawn Toole, MS,CCC-SLP

• Personal Care Attendant in Holden, LA
• Providers in Holden, LA by specialty
• Personal Care Attendant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.