Tad Christopher Tillemans, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2889 Issued in AR

Practice address

2801 Lee Ave
Little Rock, AR 72205-4327

Phone

(501) 660-6644

Fax

(501) 603-9497

NPI assigned

May 22, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Psychiatry

Education

University of Arkansas College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Counseling Services, IncGroup PAC ID 7315370103, 4 clinicians

Freshly Renewed TransitionalGroup PAC ID 9436544574, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Freshly Renewed Transitional

  • Substance Abuse Rehabilitation Facility
  • Little Rock, AR
  • NPI 1881251510
  Medicare reassignment Care Compare group NPD
• Phoenix Counseling Services, Inc.

  • Multi-Specialty Clinic/Center
  • Hot Springs, AR
  • NPI 1326690595
  Medicare reassignment Care Compare group NPD
• Lotus Valley Health and Wellness, LLC

  • Multi-Specialty Clinic/Center
  • Hot Springs, AR
  • NPI 1427797265
  Medicare reassignment NPD
• Peggy Susan Morrow, APN

  • Adult Psychiatric/Mental Health Registered Nurse
  • North Little Rock, AR
  • NPI 1174617385
  Medicare reassignment
• Lotus Valley Health and Wellness, LLC

  • Mental Health Counselor
  • Hot Springs, AR
  • NPI 1477249456
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1346459765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 LEE AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054327",
            "telephone_number": "501-660-6644",
            "fax_number": "501-603-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 LEE AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054327",
            "telephone_number": "501-660-6644",
            "fax_number": "501-603-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEMANS",
        "first_name": "TAD",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AR",
            "license": "2889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1436377001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Demarreo Tidwell, LMSW
• Grace Emma Tidwell
• Kailah L Tidwell, LAC
• Megan Tidwell
• Sara Ellen Tiefenthaler
• Clare K Tilley, APRN
• Gina Zareena Khan Tilley, MD
• James Cameron Tilley
• Jett Garrett Tilley, PHARMD
• Kirsten Victoria Tilley

• Psychiatry Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Psychiatry Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.