MR. MICHAEL TILLERY (NPI# 1164980694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164980694 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL TILLERY |
| Credential | ATC |
| Practice Address |
4350 Constellation Rd Lompoc CA 93436-1033 |
| Mailing Address |
4350 Constellation Rd Lompoc CA 93436-1099 |
| Practice Telephone | 8057422900 |
| Practice Fax Number | 8957422917 |
| Mailing Telephone | 8057422900 |
| Mailing Fax Number | 8057422917 |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
070402516 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326595786 | Michael Tillery | Registered Nurse | 65 Sail Maker Ln, Richmond Hill, GA 31324-6260 | 2016-09-02 |
| 1558725580 | Michael Andrew Tillery | Physician Assistant | 1200 N Elm St, Advanced Heart Failure Clinic, Greensboro, NC 27401-1004 | 2016-04-06 |
| 1356494462 | Michael Fredrick Tillery | Dentist | 3410 N High School Rd, Suite B, Indianapolis, IN 46224-1742 | 2007-01-19 |
| Street Address |
4350 CONSTELLATION RD |
| City | LOMPOC |
| State | CA |
| Zip Code | 93436-1033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671498 | Bonnie O'brien | Technician | 4174 Sirius Avenue, Lompoc, CA 93436 | 2019-10-21 |
| 1043734056 | Stevens Life Chiropractic, PC | Chiropractor | 217-a West Central Ave, Lompoc, CA 93436 | 2017-08-01 |
| 1548621014 | Kimberly Gaynell Wiley | Home Health Aide | 610 East Pine St #34, Lompoc, CA 93436 | 2016-03-11 |
| 1386017960 | Marcos Paul Cline | Counselor | 117 North 'b' Street, Lompoc, CA 93436 | 2015-11-04 |
| 1487045324 | Angela Rose Robinson | Case Manager/Care Coordinator | 113 North H Street, Suite F, Lompoc, CA 93436 | 2015-02-13 |
| 1851795751 | Alina Staniger | Counselor | 604 W Ocean, Lompoc, CA 93436 | 2014-10-21 |
| 1154750560 | Lompoc Valley Medical Center | General Acute Care Hospital | 303 South C Street, Lompoc, CA 93436 | 2013-11-06 |
| 1598191488 | David Lewis Mcaninch Iv | Dentist | 1111 East Ocean Avenue, Suite 9, Lompoc, CA 93436 | 2013-09-24 |
| 1336407048 | Pamela Jordan | Counselor | 110 S. 'c' St. Ste. A, Family Service Agency, Lompoc, CA 93436 | 2012-05-01 |
| 1316220874 | Zillah J. Hodgkins | Counselor | 513 N G St, Lompoc, CA 93436 | 2011-09-21 |
| Find all providers in zip 93436 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578784294 | Tom E Blanco | Specialist/Technologist | 515 W College Ave, Lompoc, CA 93436-4401 | 2007-05-01 |
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|---|---|---|---|---|
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| 1790385466 | Tamia Shoshone | Specialist/Technologist | 2823 Diaz Lane, Bishop, CA 93514 | 2020-10-30 |
| 1639779630 | Taylor Anderson | Specialist/Technologist | 3320 Honolulu Ave Apt 11, La Crescenta, CA 91214-3389 | 2020-10-28 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1063011278 | Hilary Ann King | Specialist/Technologist | 824 W Maple Ave, Tulare, CA 93274-2609 | 2020-10-19 |
| 1568069854 | Tess Buchanan | Specialist/Technologist | 4480 Leatherwood Ct, Concord, CA 94521-4416 | 2020-10-08 |
| 1407453343 | Peter Wang | Specialist/Technologist | 3034 Belmont Dr, Lodi, CA 95242-9732 | 2020-10-05 |
| 1164029138 | Marisa Angelina Terrazas | Specialist/Technologist | 1416 Rampart Dr, Roseville, CA 95661-4749 | 2020-10-02 |
| 1427665645 | Alvaro Juarez Jr. | Specialist/Technologist | 31550 Palomar Rd, Menifee, CA 92584-9258 | 2020-09-30 |
| 1407462237 | Lorenzo Aguirre | Specialist/Technologist | 1836 Lapham Dr, Modesto, CA 95354-3900 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.