Sharicka Michelle Tillman

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

3037 W 9TH St
Jacksonville, FL 32254-1957

Phone

(904) 888-1518

NPI assigned

May 28, 2021

Last updated

May 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1932775137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 W 9TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541957",
            "telephone_number": "904-888-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3037 W 9TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541957",
            "telephone_number": "904-888-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "SHARICKA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "851213923",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED",
            "identifier": "851213923",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Nannette Tillis, MD
• Tiffany Armika Tillman-Williams, RN
• Nancy T. Tillman, RN
• Noah Tillman, DC
• Shannon E Tillman, CMA
• Shaundria Tillman, LPN
• Toni Tillman
• Timothy H Tillo, D.P.M.
• Brent Justin Tilseth, M.D.
• Dan'N Ebby Khaelle Tima

• In Home Supportive Care Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.