Active NPI
Robert Harrison Tillman, MD
- Pediatric Pulmonology Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pulmonology Physician
- License
- 2020-02231
- Practice address
- 1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866 - Phone
- (704) 381-8840
- NPI assigned
- Jun 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2020-02231 | NC | |
| Pediatric Pulmonology Physician | 2080P0214X | 2020-02231 | NC | Primary |
Addresses
Primary practice location
1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
2550 Court Dr
Gastonia, NC 28054-2152
Phone (704) 381-8840
Other practice location 2
14214 Ballantyne Lake Rd
Charlotte, NC 28277-3372
Phone (704) 381-8840
Other practice location 3
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1422
Other practice location 4
100 Medical Park Dr
Ste 310
Concord, NC 28025-2948
Phone (704) 403-2660
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
| Direct Messaging Address | rtillman392957@CarolinasHealthcareSystem.direct-ci.com | Atrium Health |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Georgia College of Eclectric Medicine and Surgery, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020-02231 | NC | MD | Pediatric Pulmonology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Medical Center | Current | Accepting new patients | |
| Carolinas Medical Center | Pediatrics | Current | Accepting new patients |
| Texas Children'S Physician Group | Pediatrics | Current | Accepting new patients |
| Physicians Referral Service | Past | Accepting new patients | |
| Carolinas Medical Center | Pediatrics | Past | Accepting new patients |
Locations
1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255
100 Medical Park Dr
Ste 310
Concord, NC 28025
Phone (704) 403-2860
8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250
2450 Holcombe Blvd
Ste NB34L
Houston, TX 77021
Phone (713) 796-0003
6701 Fannin St
Ste 910
Houston, TX 77030
6701 Fannin St
Ste 1040
Houston, TX 77030
Phone (832) 822-3300
Interoperability endpoints
- rtillman392957@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Charlotte, NC
- NPI 1396986451
-
- Community/Retail Pharmacy
- Charlotte, NC
- NPI 1982710554
-
- Pediatrics Physician
- Houston, TX
- NPI 1861675506
-
- Multi-Specialty Clinic/Center
- Houston, TX
- NPI 1073574810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1346504297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BLYTHE BLVD",
"address_2": "MEDICAL CENTER PLAZA SUITE 200",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035866",
"telephone_number": "704-381-8840"
}
],
"practiceLocations": [
{
"address_1": "2550 Court Dr",
"address_purpose": "LOCATION",
"city": "Gastonia",
"state": "NC",
"postal_code": "280542152",
"country_code": "US",
"telephone_number": "704-381-8840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14214 Ballantyne Lake Rd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282773372",
"country_code": "US",
"telephone_number": "704-381-8840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1350 S Kings Dr",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282072134",
"country_code": "US",
"telephone_number": "704-446-1422",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Medical Park Dr",
"address_2": "Ste 310",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252948",
"country_code": "US",
"telephone_number": "704-403-2660",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TILLMAN",
"first_name": "ROBERT",
"middle_name": "HARRISON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2020-02231",
"primary": false
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "NC",
"license": "2020-02231",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rtillman392957@CarolinasHealthcareSystem.direct-ci.com",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "1001 Blythe Blvd",
"address_2": "Medical Center Plaza, Suite 200",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282035866",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.