Individual provider Active NPI

Augusta K Helms Tillery, SLP

  • Speech-Language Pathologist
  • Tempe, AZ
National Provider Identifier
1861555658
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0869 Issued in AZ
Practice address
Arizona St Univ Dept Speech & Hearing Sci
975 S. Myrtle Ave., Coor Hall 2211
Tempe, AZ 85287-0102
Phone
(480) 965-2373
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0869 AZ Primary

Addresses

Primary practice location

Arizona St Univ Dept Speech & Hearing Sci
975 S. Myrtle Ave., Coor Hall 2211
Tempe, AZ 85287-0102

Mailing address

Arizona St Univ Dept Speech & Hearing Sci
975 S. Myrtle Ave., Coor Hall 2211
Tempe, AZ 85287-0102
Phone (480) 965-2373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170830000107 AZ Practitioner - Qualified Speech Language Pathologist 8820361611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona State UniversityGroup PAC ID 7012997976, 9 clinicians

Practice addresses (Care Compare)

975 S Myrtle Ave
Tempe, AZ 85287-0001
Phone (480) 965-2373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0869AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona State University Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1861555658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ARIZONA ST UNIV DEPT SPEECH & HEARING SCI",
            "address_2": "975 S. MYRTLE AVE., COOR HALL 2211",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852870102",
            "telephone_number": "480-965-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ARIZONA ST UNIV DEPT SPEECH & HEARING SCI",
            "address_2": "975 S. MYRTLE AVE., COOR HALL 2211",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852870102",
            "telephone_number": "480-965-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMS TILLERY",
        "first_name": "AUGUSTA",
        "middle_name": "K",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "0869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.