KATHERINE TILLMAN (NPI# 1689030330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689030330 |
| Entity Type | Individual |
| Full Name | KATHERINE TILLMAN |
| Practice Address |
8119 N Mulberry St Tampa FL 33604-3443 |
| Practice Telephone | 8134106159 |
| Mailing Telephone | 8134106159 |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906834 | FL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266755 | Katherine Tillman | Physical Therapy Assistant | 10001 S Oswego St, Parker, CO 80134-3786 | 2020-08-18 |
| 1720648140 | Katherine Kelle Tillman | Registered Nurse | 1717 S Main St, Fort Worth, TX 76110-1626 | 2019-06-18 |
| 1437377546 | Katherine Tillman | Occupational Therapist | 45 Forest Cv, Jackson, TN 38301-4366 | 2007-04-23 |
| Street Address |
8119 N MULBERRY ST |
| City | TAMPA |
| State | FL |
| Zip Code | 33604-3443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114578838 | Gail Hartmaier | Technician | 3805 East Crenshaw Street, Tampa, FL 33604 | 2019-09-24 |
| 1023662749 | Yohana Botero | Social Worker | 6620 North Nebraska Ave, Tampa, FL 33604 | 2019-07-31 |
| 1578065025 | Linda Mcclain | Counselor | 7207 North Nebraska Avenue, Tampa, FL 33604 | 2018-03-01 |
| 1851811178 | Rosa Ramirez-tineo | Counselor | 7207 N Nebraska Avenue, Tampa, FL 33604 | 2017-06-27 |
| 1225432651 | Anna Stouffer | Nurse Practitioner | 17 Davis Blvd., Suite 402, Tampa, FL 33604 | 2014-10-14 |
| 1982028601 | Yetey Enterprises Inc Dba Springswater Alf | Assisted Living Facility | 1411 E Waters Ave, Tampa, FL 33604 | 2014-02-17 |
| 1053734301 | Yetey Enterprises Inc | Assisted Living Facility | 8602 N 22nd St, Tampa, FL 33604 | 2014-01-22 |
| 1902232887 | Sierra Alicia Montgomery | Developmental Therapist | 300 E Sligh Ave, Tampa, FL 33604 | 2013-09-23 |
| 1639432305 | Carmen's Goodcare Alf, Corp. | Assisted Living Facility | 908 W Yukon St., Tampa, FL 33604 | 2012-06-19 |
| 1427328913 | Daniellas Alf LLC | Respite Care | 1910 W Fern St, Tampa, FL 33604 | 2011-12-30 |
| Find all providers in zip 33604 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669025698 | Marcson Erdain | Custodial Care Facility | 2313 W Arch St, Tampa, FL 33607-5303 | 2019-07-18 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1437636024 | Tonia Hammond | Custodial Care Facility | 3819 Beechwood Blvd, Tampa, FL 33619-1224 | 2018-07-26 |
| 1295275360 | Myrta Cruz Rivera | Custodial Care Facility | 11008 N 52nd St, Tampa, FL 33617-2804 | 2017-03-08 |
| 1821532243 | Lawanza Llanos | Custodial Care Facility | 1911 E 143rd Ave, Tampa, FL 33613-2536 | 2016-12-05 |
| 1629526074 | Eakens Group Home | Custodial Care Facility | 8402 Rio Bravo Ct, 3, Tampa, FL 33617-7083 | 2016-09-14 |
| 1083072789 | Diane's Speial Home Care, Inc | Custodial Care Facility | 8206 Pennywell Pl, Tampa, FL 33615-1625 | 2016-02-09 |
| 1801269022 | Turning Pages LLC | Custodial Care Facility | 2931 Banza St, Tampa, FL 33605-2769 | 2015-11-10 |
| 1891170460 | Claudette Johnson | Custodial Care Facility | 4617 Hidden Shaddow Dt, Tampa, FL 33614 | 2015-07-24 |
| 1164800819 | Miledy Martinez | Custodial Care Facility | 6508 Amundson Ct, Tampa, FL 33634-4731 | 2015-05-14 |
| Find all providers in TAMPA | ||||
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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.