MR. CHARLES R TILLEY JR. (NPI# 1467502286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467502286 |
| Entity Type | Individual |
| Full Name | MR. CHARLES R TILLEY JR. |
| Practice Address |
Po Box Hh Winnebago NE 68071-0767 |
| Practice Telephone | 4028782231 |
| Practice Fax Number | 4028782236 |
| Mailing Telephone | 4028782231 |
| Mailing Fax Number | 4028782236 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2013-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1409 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 001775 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316467798 | Charles L Tilley Jr. | Behavior Technician | 4642 Bethume Dr, Shreveport, LA 71109-6634 | 2017-06-26 |
| 1023346186 | Charles Patrick Tilley | Hospice, Inpatient | 1250 Broadway, 7th Floor, New York, NY 10001-3701 | 2009-12-01 |
| Street Address |
PO BOX HH |
| City | WINNEBAGO |
| State | NE |
| Zip Code | 68071-0767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679850507 | James Nathanial Bower | Pharmacist | Po Box Hh, Winnebago, NE 68071-0767 | 2011-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242950 | Adam Lee Goetz | Pharmacist | 225 S Bluff Str, Winnebago, NE 68071 | 2020-07-08 |
| 1659932424 | Sandra Jo Kruse-anderson | Registered Nurse | 225 S. Bluff St., Winnebago, NE 68071 | 2019-06-24 |
| 1093272668 | Ricardo Osorio | Nurse Practitioner | 225 Us-75, Winnebago, NE 68071 | 2019-03-01 |
| 1891268736 | Lexa Wright | Pharmacist | 225 S Bluff St, Winnebago, NE 68071 | 2019-01-03 |
| 1245760479 | Angela Rebecca Mcelmuray Dundee | Counselor | Augustine Dr #2, Winnebago, NE 68071 | 2017-06-20 |
| 1558717074 | Winnebago Tribe of Nebraska | Community/Behavioral Health | Augustine Dr. #2, Winnebago, NE 68071 | 2016-05-13 |
| 1801260526 | Winnebago Indian Health Service | Clinic/Center | Hwy 77 75, Winnebago, NE 68071 | 2015-11-18 |
| 1528440385 | All Directions Behavioral Health, Inc. | Counselor | 202 Osborne Street, Winnebago, NE 68071 | 2015-06-29 |
| 1518249846 | Alisha Shelton | Counselor | 225 South Bluff Street, Winnebago, NE 68071 | 2011-09-13 |
| 1417251216 | Gretchen Wheelock | Nurse Practitioner | Us Highway 77-75, Winnebago, NE 68071 | 2011-01-07 |
| Find all providers in zip 68071 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184434 | Jacob Solomon Morrill | Physician Assistant | 2701 W Norfolk Ave Fl 4, Norfolk, NE 68701-4407 | 2020-11-07 |
| 1609475375 | Patrick Donald Heavey | Physician Assistant | 4660 Pine St, Omaha, NE 68106-2520 | 2020-10-22 |
| 1780297440 | Tayler Marie Llewellyn | Physician Assistant | 17241 Oak Dr, Omaha, NE 68130-2428 | 2020-08-24 |
| 1154933992 | Alexandria Rae Mctaggart | Physician Assistant | 5024 S 130th St, Omaha, NE 68137-1820 | 2020-08-22 |
| 1477170082 | Audrey Caroline Smith | Physician Assistant | 1303 N 188th St, Elkhorn, NE 68022-4501 | 2020-06-30 |
| 1851917181 | Connor Evan Bliss | Physician Assistant | 2908 W 39th St Ste D, Kearney, NE 68845-1245 | 2020-06-23 |
| 1124651443 | Kathryn A Kesti | Physician Assistant | 4242 Farnam St Ste 500, Omaha, NE 68131-2850 | 2020-02-14 |
| 1760014757 | Timothy Shew | Physician Assistant | 7500 Mercy Rd Ste 1300, Omaha, NE 68124-2319 | 2020-02-07 |
| 1659901601 | Jordan Marie Morris | Physician Assistant | 821 Bordeaux St, Chadron, NE 69337-2614 | 2020-01-17 |
| 1083264303 | Alicia K Clough | Physician Assistant | 15236 Westchester Dr, Omaha, NE 68154-2060 | 2019-09-18 |
| 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.