DR. JASON BULENT TILLEY (NPI# 1609162205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609162205 |
| Entity Type | Individual |
| Full Name | DR. JASON BULENT TILLEY |
| Credential | D.O. |
| Practice Address |
2900 S Telephone Rd Ste 250 Moore OK 73160 |
| Mailing Address |
15705 Hatterly Ln Edmond OK 73013-4179 |
| Practice Telephone | 8142321477 |
| Mailing Telephone | 8142321477 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2018-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 6304 | OK | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 36000 Darnall Loop, Crdamc, Fort Hood, TX 76544 | 2542888234 | 2542867196 |
| Street Address |
2900 S TELEPHONE RD STE 250 |
| City | MOORE |
| State | OK |
| Zip Code | 73160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962438739 | Alvin J. Bradford | Emergency Medicine | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2006-06-24 |
| 1104440619 | Kaitlin Elizabeth Shaw | Physician Assistant | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2020-05-31 |
| 1184142259 | Ashley Morgan Garrison | Physician Assistant | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2017-09-08 |
| 1760910772 | Charlysa Diana Gatlin Castillo | Nurse Practitioner | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2017-06-03 |
| 1578953394 | Shawn Musgrave | Nurse Practitioner | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2015-02-01 |
| 1740695774 | Justin Holbrook | Nurse Practitioner | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2014-06-28 |
| 1003239518 | Kristen Lanae Rosenau | Nurse Practitioner | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2936 | 2014-02-04 |
| 1912262197 | Marc Andres | Emergency Medicine | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2012-07-12 |
| 1508934431 | Jessica Dawn Hildebrand | Emergency Medicine | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2006-11-30 |
| 1013940071 | Israel Becerra | Emergency Medicine | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2006-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912209446 | Triton Emergency Medicine | Emergency Medicine | 3316 Elmo Way, Moore, OK 73160-2380 | 2010-12-05 |
| 1053541821 | Harold Nathanial Claver | Emergency Medicine | 101 Wesley Cir, Moore, OK 73160-7557 | 2009-07-15 |
| 1962438739 | Alvin J. Bradford | Emergency Medicine | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2006-06-24 |
| 1922065069 | David A Long II | Emergency Medicine | 700 S Telephone Road, Moore, OK 73160 | 2006-05-01 |
| 1043292493 | Shelly Dawn Faubion | Emergency Medicine | 303 Se 4th St, Moore, OK 73160-6709 | 2005-11-18 |
| 1851869283 | Brittney Jolene Roberts | Emergency Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2018-11-03 |
| 1437512266 | Daniel Joshua Traum | Emergency Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2016-03-30 |
| 1912332099 | Elizabeth Anne Magann | Emergency Medicine | 2900 S Telephone Rd, Moore, OK 73160-2968 | 2013-09-09 |
| 1912262197 | Marc Andres | Emergency Medicine | 2900 S Telephone Rd Ste 250, Moore, OK 73160-2969 | 2012-07-12 |
| 1417243882 | Bob Joe Schank | Emergency Medicine | 1401 Sw 34th St Ste 200, Moore, OK 73160-3059 | 2011-06-23 |
| Find all providers in MOORE | ||||
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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.