Jason Medard Tiller, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06006915A Issued in IN

Practice address

856 N Superior Dr
Crown Point, IN 46307-8299

Phone

(219) 213-3942

Fax

(219) 213-3943

NPI assigned

Dec 13, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1881401792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 N SUPERIOR DR",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078299",
            "telephone_number": "219-213-3942",
            "fax_number": "219-213-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "JASON",
        "middle_name": "MEDARD",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06006915A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whittney Thompson, NP
• Chawtipya Thupvong, MD
• Angela Belin Thurston, DO
• Kristine Tierney, CRNA
• Stacy Anne Tillberry, RN
• Ashley Danielle Tippmann, MSW, LCSW
• TMC Premier Services, Inc
• Austin Todd, PHARMD
• Karen Dianne Todd, LCSW
• Michael Francis Todd, DO

• Physical Therapy Assistant in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.