Walter Thomas Tillman III, B.C.O.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

2414 Lytle Rd Ste 202
Bethel Park, PA 15102-2755

Phone

(412) 283-4961

Fax

(412) 283-4962

NPI assigned

Aug 9, 2006

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

Practice roles

Locations

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.

• Walter T. Tillman Inc

  • Durable Medical Equipment & Medical Supplies
  • Bethel Park, PA
  • NPI 1295911477
  NPD Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1972513356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 LYTLE RD STE 202",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151022755",
            "telephone_number": "412-283-4961",
            "fax_number": "412-283-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 LYTLE RD STE 202",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151022755",
            "telephone_number": "412-283-4961",
            "fax_number": "412-283-4962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4076 Market St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170114200",
            "country_code": "US",
            "telephone_number": "412-283-4961",
            "fax_number": "412-283-4962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "WALTER",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "B.C.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bethel Park, PA
• Providers in Bethel Park, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.