ROBERT SIDNEY TILLETT JR. (NPI# 1134109465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134109465 |
| Entity Type | Individual |
| Full Name | ROBERT SIDNEY TILLETT JR. |
| Credential | MD |
| Practice Address |
3991 Dutchmans Ln Suite 300 Louisville KY 40207-4700 |
| Mailing Address |
Po Box 776351 Chicago IL 60677-6351 |
| Practice Telephone | 5028996411 |
| Practice Fax Number | 5028996413 |
| Mailing Telephone | 5025889490 |
| Mailing Fax Number | 5022725116 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2018-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
20266 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100388800 | 05 | |
| KY | PASSPORT/PASSPORT ADVANTAGE - NNS | 50030136 | 01 |
| KY | ANTHEM - NNS | 000000693343 | 01 |
| KY | CIGNA - NNS | 2542960 | 01 |
| KY | HUMANA - NNS | 000057043W | 01 |
| KY | SIHO - NNS | 118916 | 01 |
| KY | 64202666 | 05 |
| Street Address |
3991 DUTCHMANS LN SUITE 300 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598769341 | Daniel T Maurer | Orthopaedic Surgery | 3991 Dutchmans Ln, Suite 208, Louisville, KY 40207-4700 | 2005-06-09 |
| 1851720577 | Ashley Elizabeth Knable | Nurse Practitioner | 3991 Dutchmans Ln, Suite 310, Louisville, KY 40207-4700 | 2013-11-04 |
| 1639445513 | John Perpich | Pharmacist | 3991 Dutchmans Ln, Louisville, KY 40207-4700 | 2012-03-26 |
| 1477846798 | Community Medical Associates, Inc. | Durable Medical Equipment & Medical Supplies | 3991 Dutchmans Ln, Ste. 208, Louisville, KY 40207 | 2011-05-19 |
| 1720388010 | Evelyn Marrett Beckman | Nurse Practitioner | 3991 Dutchmans Ln, Suite 405, Louisville, KY 40207-4700 | 2010-11-02 |
| 1205164936 | Dale Vincent | Nurse Practitioner | 3991 Dutchmans Ln, Norton Suburban Medical Plaza II, Suite 405, Louisville, KY 40207-4700 | 2009-11-18 |
| 1407018187 | Mark Paul Bazant | Psychiatry & Neurology | 3991 Dutchmans Ln, Suite 310, Louisville, KY 40207-4700 | 2008-06-25 |
| 1831358506 | Geeta Aruna Ganesh | Psychiatry & Neurology | 3991 Dutchmans Ln, Suite 310, Louisville, KY 40207-4700 | 2008-06-06 |
| 1013193077 | Lambert, Klamer and Gupta, Psc | Surgery | 3991 Dutchmans Ln, Suite 103, Louisville, KY 40207-4700 | 2008-01-21 |
| 1821273830 | Kimberly Michele Kisegy | Nurse Practitioner | 3991 Dutchmans Ln, Louisville, KY 40207-4700 | 2008-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336622570 | Boulder Neurology and Concussion | Psychiatry & Neurology | 400 Mccaslin Blvd, Suite 200, Louisville, CO 80027 | 2018-09-13 |
| 1114372141 | Marwa Ali Mahgoub Elnazeir | Psychiatry & Neurology | 401 E Chestnut St Ste 500, Louisville, KY 40202-5700 | 2016-04-27 |
| 1427411537 | James Lamb | Psychiatry & Neurology | 500 S Preston St Dept Of, Hsc #113, Louisville, KY 40202-1702 | 2016-04-05 |
| 1194111807 | Murali Kolikonda | Psychiatry & Neurology | 500 S. Preston St., Rm. 113, Louisville, KY 40202 | 2015-04-09 |
| 1023317633 | Alicia Erin Bennett | Psychiatry & Neurology | 100 Health Park Drive, Louisville, CO 80027 | 2011-03-22 |
| 1477879815 | Victoria Holiday | Psychiatry & Neurology | 220 Abraham Flexner Way Ste 606, Louisville, KY 40202-3826 | 2010-04-09 |
| 1285871525 | Asad Ismail Psychytry Neurology Services, Psc | Psychiatry & Neurology | 10210 Springhurst Garden Circle, Louisville, KY 40241 | 2009-01-08 |
| 1164674891 | Jignesh Jagdish Shah | Psychiatry & Neurology | 401 East Chestnut Street, Ste #510, Msc 1063, Louisville, KY 40202-5710 | 2008-10-13 |
| 1285821876 | Brian Maxwell Plato | Psychiatry & Neurology | 3991 Dutchmans Ln Ste 200, Louisville, KY 40207-4723 | 2007-09-27 |
| 1386845378 | George W Scott II | Psychiatry & Neurology | 3900 Kresge Way Ste 56, Louisville, KY 40207-1144 | 2007-05-29 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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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.