MRS. SHANNON E TILLMAN CMA
NPI 1245965144
Adult Companion in Jacksonville, FL

Q: What is Shannon Tillman's NPI number?

The NPI number for Shannon Tillman is 1245965144. It was assigned to this individual provider in the NPPES registry on July 24, 2022. The provider is also known as Ms. Shannon E Gibson Cma.

Q: What is Shannon Tillman's specialty?

The primary specialty registered for this NPI is Adult Companion with taxonomy code 372600000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Tillman was last updated on July 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 24, 2022

3104 W 12TH ST, JACKSONVILLE, FL 32254(413) 686-2639(904) 212-1996 Get Directions Write a Review

NPPES record last updated: July 25, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 25, 2022, Jul 24, 2022 (2 updates tracked since 2022).

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About Mrs. Shannon E Tillman Cma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SHANNON E TILLMAN CMA (NPI 1245965144) is an individual adult companion provider in Jacksonville, Florida, licensed in Florida (238705) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1245965144

Entity TypeIndividualFemale

Primary Taxonomy372600000X

Provider Legal NameMRS. SHANNON E TILLMANCredential: CMA

Location Address3104 W 12TH STJacksonville, FL 32254-1808

Mailing Address6501 Arlington Expy Ste B105Jacksonville, FL 32211-0810 · (904) 351-6479 · Fax (904) 212-1996

Phone(413) 686-2639

Fax(904) 212-1996

Sole ProprietorNo

Enumeration DateJuly 24, 2022

Last NPPES UpdateJuly 25, 20222 updates tracked since enumeration

NPPES CertifiedJuly 25, 2022

✔ NPI 1245965144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAdult CompanionNursing Service Related Providers

Taxonomy Code372600000X

License✔ Licensed in FL · 238705

Definition

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.

Also ListedHomemakerTaxonomy 376J00000X · License 238705 (FL)

3104 W 12TH ST, Jacksonville, FL 32254

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Other Names 1

Former Name (1)Ms. Shannon E Gibson Cma

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAGAN ASSISTED LIVING FACILITY

Assisted Living Facility

3104 W 12TH ST
JACKSONVILLE, FL 32254

Duval County (904) 382-3655

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Tillman's NPI number?

The NPI number for Shannon Tillman is 1245965144. It was assigned to this individual provider in the NPPES registry on July 24, 2022. The provider is also known as Ms. Shannon E Gibson Cma.

Where is Shannon Tillman located?

Shannon Tillman practices at 3104 W 12th St, Jacksonville, FL 32254. The listed phone number is (413) 686-2639.

What is Shannon Tillman's specialty?

The primary specialty registered for this NPI is Adult Companion with taxonomy code 372600000X.

When was this NPI record last updated?

The NPPES record for Shannon Tillman was last updated on July 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.