Individual provider Active NPI

Tague McIllwain

  • Family Nurse Practitioner
  • Madison, TN
National Provider Identifier
1053222927
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
42084 Issued in TN
Practice address
1221 Briarville Rd
Madison, TN 37115-5145
Phone
(615) 410-4990
NPI assigned
Sep 16, 2026
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 42084 TN Primary

Addresses

Primary practice location

1221 Briarville Rd
Madison, TN 37115-5145

Mailing address

331 Indian Lake Rd
Hendersonville, TN 37075-4537
Phone (615) 852-9303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1053222927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 INDIAN LAKE RD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370754537",
            "telephone_number": "615-852-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 BRIARVILLE RD",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155145",
            "telephone_number": "615-410-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILLWAIN",
        "first_name": "TAGUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "42084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.