MRS. SHANNON E TILLMAN CMA NPI 1245965144

NPI Information

  • NPI: 1245965144
  • Provider Name: MRS. SHANNON E TILLMAN, CMA
  • Classification: Adult Companion - 372600000X
  • Entity Type: Individual
  • Address: 3104 W 12TH ST
    JACKSONVILLE, FL
    ZIP 32254
  • Phone: (413) 686-2639

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NPI Details

MRS. Shannon E Tillman, CMA is an adult companion in Jacksonville, FL. The provider is an individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. MRS. Shannon E Tillman, CMA NPI is 1245965144. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3104 W 12TH ST
JACKSONVILLE, FL
ZIP 32254-808
Phone: (413) 686-2639
Fax: (904) 212-1996

The enumeration date for this NPI number is 7/24/2022 and was last updated on 7/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1376J00000XHomemaker238705FLORIDANo
2372600000XAdult Companion238705FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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