Kelsey Lyn Tillman, DNP, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021007044 Issued in MO

Practice address

500 Market St Ste 300
Fulton, MO 65251-2808

Phone

(573) 200-6078

Fax

(833) 817-7109

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1104411230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARKET ST STE 300",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512808",
            "telephone_number": "573-200-6078",
            "fax_number": "833-817-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARKET ST STE 300",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652512808",
            "telephone_number": "573-200-6078",
            "fax_number": "833-817-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "KELSEY",
        "middle_name": "LYN",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2015001994",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021007044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Thomas
• Joshua Stephen Thompson, ATC/LAT
• Samantha Paige Thompson, FNP-C
• Sophi Thurman, MD
• Carla Tigue
• Louis Lemoine Tisch Jr., DC
• Alyssa Toalson, PT
• Total Health & Rehabilitation Center
• Total Health and Rehabilitation Center PC
• Total Health and Rehabilitation Center, PC

• Family Nurse Practitioner in Fulton, MO
• Providers in Fulton, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.