Timberlake Estates SLF, LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TIMBERLAKE ESTATES SLF, LP

Practice address

2521 Empowerment Rd
Springfield, IL 62703-4983

Phone

(217) 321-2100

Fax

(217) 321-2130

NPI assigned

Sep 17, 2014

Last updated

Jun 1, 2016By 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

Mrs. Teri D Cooper

Title

Medicare Billing Facilitator

Phone

(217) 732-5119

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1851793285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 EMPOWERMENT RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034983",
            "telephone_number": "217-321-2100",
            "fax_number": "217-321-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 EMPOWERMENT RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034983",
            "telephone_number": "217-321-2100",
            "fax_number": "217-321-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERLAKE ESTATES SLF, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICARE BILLING FACILITATOR",
        "authorized_official_telephone_number": "217-732-5119",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205917599001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Till, OTR/L
• Gretchen Till, MOTOTRL
• Nicholas M. Till, CRNA
• Jennifer Lynn Tillberg-McCoy, CRNA
• Kenna Tillman, CST, CSFA
• Timberlake Senior Living
• Rachel Paige Tindall, M.D.
• Imani Tiney
• Tiffany Yvonne Tinker, LPC
• Jennifer K. Tinsley, NP

• Assisted Living Facility in Springfield, IL
• Providers in Springfield, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.