NPIMap

Individual provider Active NPI

Landi M Tillis

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1962036939
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61349220 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-0001
Phone
(000) 000-0000
NPI assigned
Feb 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61349220 WA
Family Nurse Practitioner 363LF0000X AP61349220 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-0001

Mailing address

2000 Hospital Dr
Sedro Woolley, WA 98284-4327

Other practice location 1

901 S 5th St
Mount Vernon, WA 98274-3942
Phone (360) 428-6434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927002275 WA Practitioner - Nurse Practitioner 8628454733 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

901 S 5TH St
Mount Vernon, WA 98274-3942
Phone (360) 428-6434

Hospital & facility affiliations

  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61349220WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Washington PLLC Nurse Practitioner CurrentSince Sep 1, 2022 Accepting new patients
Public Hospital District No 1 Skagit CurrentSince Dec 2, 2024 Accepting new patients
Whidbey Island Public Hospital District CurrentSince Jan 1, 2024 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Dec 2, 2024 Accepting new patients
Whidbey Island Public Hospital District CurrentSince Jan 1, 2024 Accepting new patients
Cogent Healthcare of Washington, PC Nurse Practitioner CurrentSince Aug 27, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
South Sound Inpatient Physicians, PLLC CurrentSince Aug 27, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Aug 27, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Nurse Practitioner Current Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

2320 Freeway Dr
Mount Vernon, WA 98273
Phone (360) 814-6800

901 S 5th St
Mount Vernon, WA 98274
Phone (360) 428-6434

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Interoperability endpoints

  • Direct secure messaging: ltillis61601@skagit.direct-ci.com
  • Direct secure messaging: ltillis566699@direct.peacehealth.org

Organizations & group practices 12

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1962036939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HOSPITAL DR",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982844327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982743942",
            "country_code": "US",
            "telephone_number": "360-428-6434",
            "fax_number": "360-848-4547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLIS",
        "first_name": "LANDI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-27",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61349220",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61349220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.