Individual provider Active NPI

Hailey Tillman, DC

  • Chiropractor
  • Alma, GA
National Provider Identifier
1982234233
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010326 Issued in GA
Practice address
702 S Church St
Alma, GA 31510-3124
Phone
(912) 388-6724
NPI assigned
Jan 24, 2020
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010326 GA Primary

Addresses

Primary practice location

702 S Church St
Alma, GA 31510-3124

Mailing address

119 Millbrook LN
Alma, GA 31510-1576

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630002941 GA Practitioner - Chiropractic 1951724467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

133 Ga-32 Bypass a
Alma, GA 31510
Phone (912) 632-7938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR010326GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Emh A2 CD, LLC Single Specialty Current Accepting new patients
Roots Chiropractic and Wellness Chiropractor CurrentSince Jan 30, 2020 Accepting new patients

Locations

133 GA Highway 32 Byp
Ste A
Alma, GA 31510
Phone (912) 632-7938

702 S Church St
Alma, GA 31510
Phone (912) 288-7882

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1982234233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MILLBROOK LN",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315101576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S CHURCH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315103124",
            "telephone_number": "912-388-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "HAILEY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.