Charles P Tillman Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

519 Issued in MS

Practice address

3126 E Roane Ave
Eupora, MS 39744-2638

Phone

(662) 258-2020

Fax

(662) 258-2030

NPI assigned

Sep 20, 2006

Last updated

May 27, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ms Eye Care PAGroup PAC ID 3274814207, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004

Merit-based Incentive Payment System (MIPS)

Final score

17.11 of 100Reported as individual

Quality

31.67

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Clinic of Eupora, Inc

  • Optometrist
  • Eupora, MS
  • NPI 1033240825
  Medicare reassignment NPD Authorized official
• Ms Eye Care PA

  dba Meridian Eye Care

  • Optometrist
  • Meridian, MS
  • NPI 1639530454
  Medicare reassignment Care Compare group NPD
• Eye Clinic of West Point, Inc

  • Optometrist
  • West Point, MS
  • NPI 1396879912
  Medicare reassignment NPD
• Ms Eye Care, PA

  dba Mississippi Eye Care Eupora

  • Optometrist
  • Eupora, MS
  • NPI 1356238943
  NPD
• Eye Clinic of Houston Inc

  • Optometrist
  • Houston, MS
  • NPI 1548314818
  NPD (past)

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

• North Mississippi Medical Center, Inc.

  dba North Mississippi Medical Center

  • General Acute Care Hospital
  • Tupelo, MS
  • NPI 1598875460
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1275630626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 225",
            "address_2": "3126 E ROANE AVE",
            "city": "EUPORA",
            "state": "MS",
            "postal_code": "397440225",
            "telephone_number": "662-258-2020",
            "fax_number": "662-258-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3126 E ROANE AVE",
            "city": "EUPORA",
            "state": "MS",
            "postal_code": "397442638",
            "telephone_number": "662-258-2020",
            "fax_number": "662-258-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "CHARLES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087039",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1772968",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sky Family Dental, LLC
• Specialty Orthopedic Group of Ms PLLC
• Stephen S. Wooten DDS PA
• Supervalue Pharmacy
• Abby Sutton, FNP C
• Laurie Turnipseed, PHARM.D.
• Christy Vowell, D.O.
• Walgreen Co (Murphy Drug #15804, Powered by Walgreens)
• Webster County Schools
• Webster Health Services Inc (Webster Health Providers)

• Optometrist in Eupora, MS
• Providers in Eupora, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.