Eric Wade Tillotson

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26941 Issued in MS

Practice address

1665 South Green Street
Tupelo, MS 38804

Phone

(662) 377-2189

Fax

(662) 377-2263

NPI assigned

Mar 31, 2016

Sex

Male

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 AL, FL, MS3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Family Practice

Education

University of Mississippi School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Desoto Family Medical CenterGroup PAC ID 2567470412, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Desoto Family Medical Center

  • Family Medicine Physician
  • Southaven, MS
  • NPI 1528150398

  Family Medicine, MS

  Medicare reassignment Care Compare group NPD
• Relias Hospitalist Medicine Specialists of West Point LLC

  • Hospitalist Physician
  • West Point, MS
  • NPI 1821638578

  MS

  Medicare reassignment NPD
• Baycare Medical Group, Inc.

  • General Practice Physician
  • Clearwater, FL
  • NPI 1043269871

  Family Medicine, FL

  Medicare reassignment NPD
• Marion Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Hamilton, AL
  • NPI 1932160082

  AL

  Medicare reassignment NPD
• Pinnacle Physician Group, LLP

  • Hospitalist Physician
  • Tuscaloosa, AL
  • NPI 1609008176

  AL

  Medicare reassignment NPD
• Summit Physician Group LLP

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1104343581

  AL, Family Medicine

  Medicare reassignment NPD
• Baycare Medical Group, Inc

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1497117329

  Family Medicine

  NPD
• Baycare Medical Group, Inc.

  • Family Medicine Physician
  • Clearwater, FL
  • NPI 1659720837

  Family Medicine

  NPD
• Marion Regional Medical Center, Inc

  • Multi-Specialty Clinic/Center
  • Hamilton, AL
  • NPI 1992546758
  NPD
• Marion Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Hamilton, AL
  • NPI 1205254356
  NPD

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

• Sta-Home Health Agency of Greenwood, Inc.

  • Home Health Agency
  • Greenwood, MS
  • NPI 1235270588
  Care Compare affiliation

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1316300080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 SOUTH GREEN STREET",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38804",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 SOUTH GREEN STREET",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "38804",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "ERIC",
        "middle_name": "WADE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "26941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Thornton
• Deidra N Thrasher
• Abigail Tidwell, OTD, OTR
• Elesha P Tidwell, FNP
• Tanya Tigner
• Ethan Tillotson, M.D.
• Madison Nash Timmons
• Terry V Timmons, LPC
• Tina Dye Counseling, PLLC
• James Paul Tinsley

• All providers in Tupelo, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.