Charles O Tillman III, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3469 Issued in OK

Practice address

1201 Heritage Cir
Pawnee, OK 74058-3744

Phone

(918) 762-6653

Fax

(918) 762-6656

NPI assigned

Dec 7, 2005

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 TX

Enrollment records 1

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 and National Provider Directory roles.

• Pawnee Indian Health Center

  • Clinic/Center
  • Pawnee, OK
  • NPI 1629174081

  TX

  Medicare reassignment NPD
• Pawnee IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Pawnee, OK
  • NPI 1124178017
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336124809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 E LAKEVIEW RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740753022",
            "telephone_number": "405-624-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HERITAGE CIR",
            "city": "PAWNEE",
            "state": "OK",
            "postal_code": "740583744",
            "telephone_number": "918-762-6653",
            "fax_number": "918-762-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "CHARLES",
        "middle_name": "O",
        "name_suffix": "III",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "3469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stillwater Medical Center Authority
• Jo Lynn Strate
• Belinda Stubblefield
• Brooke Tatum
• The Pawnee Clinic Inc
• Manon Danette Tillman, RN
• Karyn L Todd
• United Community Action Program, Inc.
• Unity Healthcare Association
• Wade Wellness, PLLC

• Physical Therapist in Pawnee, OK
• Providers in Pawnee, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.