Tara Leann Tillman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

907184 Issued in MS

Practice address

103 W Frontage Rd
Lucedale, MS 39452-5836

Phone

(601) 947-9596

NPI assigned

Jun 28, 2025

Last updated

Jul 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Lucedale Urgent Care, PC

  • Multi-Specialty Clinic/Center
  • Lucedale, MS
  • NPI 1700372034
  Medicare reassignment NPD
• J Fails, LLC

  dba Lucedale Pediatrics

  • Primary Care Clinic/Center
  • Lucedale, MS
  • NPI 1851980379
  NPD (past)

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

{
    "created_epoch": "1751068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1245129030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 JAKE HILL RD",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394522093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W FRONTAGE RD",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394525836",
            "telephone_number": "601-947-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "TARA",
        "middle_name": "LEANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-28",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Stringfellow, RPH
• Anna Smith Sublett, PHARMD
• Valerie S Sullivan, PT
• Darvin Rickey Tanner Sr., RN
• Tera Walters Therapy LLC
• Kristen Ana Trainer, OD
• Jessica Hope Turner, PMHNP
• Stacy A Upshaw, M.D.
• Courtney Louise Valentine, M.D.
• Leslie Helen Valentine, OD

• Family Nurse Practitioner in Lucedale, MS
• Providers in Lucedale, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.