Individual provider Active NPI

Ashlee Nicole Sharer Tillery, MD

  • Obstetrics & Gynecology Physician
  • Vidalia, GA
National Provider Identifier
1356876197
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
89018 Issued in GA
Practice address
101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852
Phone
(912) 537-1014
Fax
(912) 538-0979
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 89018 GA Primary

Addresses

Primary practice location

101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852

Mailing address

101 Harris Industrial Blvd Ste C
Vidalia, GA 30474-8852
Phone (912) 537-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20210813002484 GA Practitioner - Obstetrics/Gynecology 5193096436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadows Multispecialty Associates LLCGroup PAC ID 6002223484, 28 clinicians

Practice addresses (Care Compare)

101 Harris Industrial Blvd
Suite C
Vidalia, GA 30474-8852
Phone (912) 537-1014

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
76.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
009002GAMDProfessional Counselor
89018GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadows Multispecialty Associates, LLC CurrentSince Aug 23, 2021 Accepting new patients
Vidalia Health Services, LLC Past Accepting new patients

Locations

11 Johnson St
Hazlehurst, GA 31539
Phone (800) 367-0816

101 Harris Industrial Blvd
Ste C
Vidalia, GA 30474

1707 Meadows Ln
Ste A
Vidalia, GA 30474
Phone (912) 538-0003

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: ashlee.tillery@hca5.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1356876197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD STE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD STE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLERY",
        "first_name": "ASHLEE NICOLE",
        "middle_name": "SHARER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "89018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.