Noah Tillman, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH15233 Issued in FL

Practice address

6850 103Rd St Ste 3
Jacksonville, FL 32210-6877

Phone

(256) 595-2891

NPI assigned

Oct 21, 2024

Sex

Male

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 FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chanatrydc, LLCGroup PAC ID 5698912194, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Chanatrydc, LLC

  dba Chanatry Chiropractic

  • Chiropractor
  • Jacksonville, FL
  • NPI 1376883298
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1801617063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 WANING WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568259",
            "telephone_number": "256-595-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 103RD ST STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106877",
            "telephone_number": "256-595-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "NOAH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH15233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryce R Tiller, MD
• Mallory Lynn Tillis, SLP
• Tina Nannette Tillis, MD
• Tiffany Armika Tillman-Williams, RN
• Nancy T. Tillman, RN
• Shannon E Tillman, CMA
• Sharicka Michelle Tillman
• Shaundria Tillman, LPN
• Toni Tillman
• Timothy H Tillo, D.P.M.

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.