CONLEY TILLMAN JR. (NPI# 1629549423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629549423 |
| Entity Type | Individual |
| Full Name | CONLEY TILLMAN JR. |
| Practice Address |
2624 Lexington Ave Springfield OH 45505-2620 |
| Practice Telephone | 9373285300 |
| Practice Fax Number | 9373224900 |
| Mailing Telephone | 9373285300 |
| Mailing Fax Number | 9373224900 |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | W.1800116 | OH | Behavioral Health & Social Service Providers |
| Y | 171M00000X | Case Manager/Care Coordinator | CDCA.166069 | OH | Other Service Providers |
| Street Address |
2624 LEXINGTON AVE |
| City | SPRINGFIELD |
| State | OH |
| Zip Code | 45505-2620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013961945 | Mckinley Hall, Inc. | Substance Abuse Rehabilitation Facility | 2624 Lexington Ave, Springfield, OH 45505 | 2006-05-22 |
| 1801414636 | Kylie Nicole Getz | Counselor | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2020-07-08 |
| 1043837594 | Kaitlyn E Lough | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2020-07-01 |
| 1942821756 | Joshua Paul Bilunka | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2020-05-04 |
| 1134758378 | Tina L Crace | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2020-04-08 |
| 1265069637 | Grant E Kunkle | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2020-03-25 |
| 1679110639 | Joirdin Nicole Quinn | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2019-12-09 |
| 1265079222 | Anthony Duane Moore Jr. | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2019-12-09 |
| 1497396055 | Ashley W Roach | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2019-10-04 |
| 1922655760 | Timothy Michael Huber | Case Manager/Care Coordinator | 2624 Lexington Ave, Springfield, OH 45505-2620 | 2019-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871089680 | Jessica Renee Wallace | Nurse Practitioner | 1821 E. High St., Springfield, OH 45505 | 2018-07-04 |
| 1912317108 | Merek Ramirez | Counselor | 363 S Burnett Road, Back Office, Springfield, OH 45505 | 2014-04-28 |
| 1760736045 | Pamela Kay Beatty | Licensed Practical Nurse | 422 Rice St, Springfield, OH 45505 | 2012-11-07 |
| 1285997676 | Tylin Yvette January | Licensed Practical Nurse | 720 Mound Street, Springfield, OH 45505 | 2012-06-20 |
| 1639457492 | Sherry Robinette | Dentist | 3471 East National Road, Springfield, OH 45505 | 2011-07-28 |
| 1124324116 | Kncc Enterprise, LLC | Physical Therapist | 155 South Tuttle Road, Springfield, OH 45505 | 2011-02-08 |
| 1316272420 | Rocking Horse Children's Health Center | Clinic/Center | 651 South Limestone Streeet, Springfield, OH 45505 | 2009-10-07 |
| 1326269101 | Jeffrey L Kearfott | Ophthalmology | 20 South Burnett, Springfield, OH 45505 | 2007-05-01 |
| 1932274511 | Whitacre Pharmacies LLC | Pharmacy | 1816 S Limestone St, Springfield, OH 45505 | 2006-11-21 |
| 1114024569 | Clark County Sheriff's Office | Public Health or Welfare | 3130 E. National Rd., Springfield, OH 45505 | 2006-09-20 |
| Find all providers in zip 45505 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
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|---|---|---|---|---|
| 1831745728 | Affinity Patient Coordination LLC | Case Manager/Care Coordinator | 217 E Monroe St Ste 204, Springfield, IL 62701-1746 | 2019-08-15 |
| 1578075107 | Christopher Worthen | Case Manager/Care Coordinator | 223 N Western Ave, Springfield, OH 45504-2719 | 2017-11-06 |
| 1497204622 | Inesha Simmons | Case Manager/Care Coordinator | 1331 Denison Dr, Apt C, Springfield, IL 62704-4454 | 2016-09-29 |
| 1235687138 | Yvonne Persley | Case Manager/Care Coordinator | 8 Allison Ct, Springfield, IL 62703-1130 | 2016-09-20 |
| 1902255516 | Dionna Marino | Case Manager/Care Coordinator | 731 Cheatham Street, Springfield, TN 37172 | 2016-06-06 |
| 1972918423 | Loree Lynn Howard | Case Manager/Care Coordinator | 4145 Jasper Road, Springfield, OR 97478 | 2014-06-24 |
| 1871907824 | Latisha Robinson | Case Manager/Care Coordinator | 3050 S National Ave Ste 104, Springfield, MO 65804-4242 | 2014-06-18 |
| 1548601792 | Richard S Buford | Case Manager/Care Coordinator | 1086 Mound St, Springfield, OH 45505-1191 | 2013-07-16 |
| 1164765228 | Colleen K Webb | Case Manager/Care Coordinator | 285 Third St. Extension, Springfield, GA 31329-1612 | 2013-03-27 |
| 1447503636 | Lifetime Support Incorporated | Case Manager/Care Coordinator | 52 Fadem Rd, Springfield, NJ 07081-3116 | 2012-10-25 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 45505 |
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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.