Tilley Diagnostic Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C7758 Issued in AR

Legal business name

TILLEY DIAGNOSTIC CLINIC

Doing business as

Pinnacle Physicians Group

Practice address

1003 Schneider Dr
Malvern, AR 72104-4811

Phone

(501) 337-5678

Fax

(501) 332-6759

NPI assigned

Aug 5, 2006

Last updated

Dec 9, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Absalom H Tilley, M.D.NPI 1275558918

Title

Owner

Phone

(501) 337-5678

Specialties & licenses 6

Addresses

Other names 1

• Pinnacle Physicians Group Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Absalom H Tilley, M.D.

  • Internal Medicine Physician
  • Malvern, AR
  • NPI 1275558918
  Authorized official Same address or phone
• Sandy Lynn King, APRN

  • Family Nurse Practitioner
  • Hot Springs, AR
  • NPI 1972270445
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1831108331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 SCHNEIDER DR",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044811",
            "telephone_number": "501-337-5678",
            "fax_number": "501-332-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SCHNEIDER DR",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044811",
            "telephone_number": "501-337-5678",
            "fax_number": "501-332-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLEY DIAGNOSTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "ABSALOM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-337-5678",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "C7758",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AR",
            "license": "E5172",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E5062",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "GL008",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "P01341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pinnacle Physicians Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Crossing at Malvern
• Theraputic Family Services
• Pamela J Thomas, MHPP
• Julie A Thompson, COTA/L
• Jamall Tidwell, MHPP
• Absalom H Tilley, M.D.
• Tisha R. Jenkins, LCSW P.a.
• Makayla Tolliver
• Jasmine Traylor
• Martrel M Traylor, RECOVERY ASSISTANT

• Internal Medicine Physician in Malvern, AR
• Providers in Malvern, AR by specialty
• Internal Medicine Physician in Arkansas

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

Verify at the official NPI Registry.