Jordan Gabrielle Tillery

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

501 SW 23Rd St
El Reno, OK 73036-5855

Phone

(405) 503-5672

NPI assigned

Aug 9, 2024

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

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1821829003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SW 23RD ST",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730365855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SW 23RD ST",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730365855",
            "telephone_number": "405-503-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "JORDAN",
        "middle_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Lynne Thomas
• Jordan Thomas
• Elisa D Thompson
• Latasha D Thornburg
• Kaycee Threatt
• Elizabeth Tom, QBHP
• Trevor White, O.D., P.C.
• Angela Trujillo
• Lori Lee Tsosie, P.T.
• Shannon Renee Tucker

• Peer Specialist in El Reno, OK
• Providers in El Reno, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.