Courtenay L Tillman, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN 159370NP Issued in GA

Practice address

586 Brannen St
Statesboro, GA 30458-5557

Phone

(912) 871-6611

Fax

(912) 871-6612

NPI assigned

Aug 31, 2006

Last updated

Sep 1, 2015By 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• Georgia Emergency Associates

  • Emergency Medicine Physician
  • Rincon, GA
  • NPI 1528098290
  NPD (past)
• Montgomery Emergency Group, LLC

  • Emergency Medicine Physician
  • Vidalia, GA
  • NPI 1861773764
  NPD (past)
• South Georgia Internal Medicine,PC

  • Internal Medicine Physician
  • Swainsboro, GA
  • NPI 1689738700
  NPD (past)
• Southeast Medical Group, P.C.

  dba North Atlanta Primary Care, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1285746941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 BRANNEN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585557",
            "telephone_number": "912-871-6611",
            "fax_number": "912-871-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 BRANNEN ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585557",
            "telephone_number": "912-871-6611",
            "fax_number": "912-871-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "COURTENAY",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN 159370NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "901106018A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00351681",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF GA GROUP #",
            "identifier": "061407",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Leanna Thompson, AT
• Rachel Thompson
• Katie Thomsen, PT, DPT
• Thrive Health and Wellness LLC
• Caroline Thurman, LPC
• Kelly Tillman
• Carlie Tilson
• Paul J Tilson, MD
• Lynly Rose Timmerman
• Todd Allen MD PC

• Family Nurse Practitioner in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.