Individual provider Active NPI

Jennifer Joan Tillman, NP-C

  • Family Nurse Practitioner
  • Perrysburg, OH
National Provider Identifier
1134536840
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15986 Issued in OH
Practice address
30000 E River Rd
Perrysburg, OH 43551-3429
Phone
(419) 931-3440
Fax
(419) 661-4020
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.15986 OH
Family Nurse Practitioner 363LF0000X 15986 OH Primary

Addresses

Primary practice location

30000 E River Rd
Perrysburg, OH 43551-3429

Mailing address

801 Rosehill Rd
Jackson, MI 49202-1762
Phone (517) 212-2008

Other practice location 1

3550 Briarfield Blvd
Suite 300
Maumee, OH 43537-9184
Phone (419) 452-2140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtillman13227@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141110001581 OH Practitioner - Nurse Practitioner 0446472377 Reassigns benefits to 3 organizations
I20260106001309 MI Practitioner - Nurse Practitioner 0446472377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hospice of Northwest OhioGroup PAC ID 8527150721, 17 clinicians

Practice addresses (Care Compare)

30000 E River Rd
Perrysburg, OH 43551-3429
Phone (419) 661-5110

8132 Secor Rd
Lambertville, MI 48144-8673
Phone (419) 661-4001

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15986OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice of Northwest Ohio CurrentSince Feb 24, 2025 Accepting new patients
Promedica Central Physicians CurrentSince Oct 1, 2014 Accepting new patients
Careline Poh100 LLC CurrentSince May 13, 2024 Accepting new patients
Promedica Central Physicians CurrentSince Oct 1, 2014 Accepting new patients
Hospice of Northwest Ohio PastSince Feb 24, 2025 Accepting new patients

Locations

801 Rosehill Rd
Jackson, MI 49202
Phone (517) 212-2008

8132 Secor Rd
Lambertville, MI 48144
Phone (419) 661-4001

3550 Briarfield Blvd
Ste 300
Maumee, OH 43537
Phone (419) 452-2102

30000 E River Rd
Perrysburg, OH 43551
Phone (419) 661-4001

2121 Hughes Dr
Ste 830
Toledo, OH 43606

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1134536840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "517-212-2008",
            "fax_number": "517-212-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30000 E RIVER RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513429",
            "telephone_number": "419-931-3440",
            "fax_number": "419-661-4020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 Briarfield Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Maumee",
            "state": "OH",
            "postal_code": "435379184",
            "country_code": "US",
            "telephone_number": "419-452-2140",
            "fax_number": "419-873-6327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "JENNIFER",
        "middle_name": "JOAN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.15986",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "15986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtillman13227@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.