Corah L Tillerson, PA

Key facts

NPI

1508551458

Entity type

Individual (NPI type 1)

Primary specialty

Medical Physician Assistant 363AM0700X

License

0110009563 (VA)

Practice address

57 Beam LN Ste 300
Fishersville, VA 22939-2350

Phone

(434) 297-9999

Fax

(434) 297-9898

NPI assigned

Apr 6, 2023

Sex

Female

Sole proprietor

No

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.

• Uva Community Health Medical Group, LLC Multi-Specialty Clinic/Center · Charlottesville, VA · NPI 1598475741
  Medicare reassignment Care Compare group NPD VA
• Mary Washington Healthcare Physicians Family Medicine Physician · Fredericksburg, VA · NPI 1295999852
  Medicare reassignment NPD HEMATOLOGY & ONCOLOGY · VA
• University of Virginia Physicians Group Sports Medicine (Neuromusculoskeletal Medicine) Physician · Charlottesville, VA · NPI 1033138250
  Medicare reassignment NPD VA
• Uva Community Health Medical Group, LLC Cardiovascular Disease Physician · Falls Church, VA · NPI 1780065656
  Care Compare group
• Mary Washington Healthcare Physicians Durable Medical Equipment & Medical Supplies · Fredericksburg, VA · NPI 1740853035
  NPD
• Uva Community Health Medical Group, LLC Critical Care Medicine (Internal Medicine) Physician · Manassas, VA · NPI 1639618960
  NPD

Hospital & facility affiliations 3

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

• Augusta Health Care, Inc General Acute Care Hospital · Fishersville, VA · NPI 1053301127
  Care Compare affiliation Hospital
• Rector & Visitors of the University of Virginia General Acute Care Hospital · Charlottesville, VA · NPI 1780630608
  Care Compare affiliation Hospital
• Sentara RMH Medical Center General Acute Care Hospital · Harrisonburg, VA · NPI 1780694372
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uva Community Health Medical Group LLC (339 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Virginia Medical Center Hospital · Charlottesville, VA · CCN 490009
• Augusta Health Hospital · Fishersville, VA · CCN 490018
• Sentara RMH Medical Center Hospital · Harrisonburg, VA · CCN 490004

Medicare participation

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckaufman649420@direct.healthsystem.virginia.edu

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 3, 2025.

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1508551458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BEAM LN STE 300",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392350",
            "telephone_number": "434-297-9999",
            "fax_number": "434-297-9898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229082582",
            "country_code": "US",
            "telephone_number": "434-924-9333",
            "fax_number": "434-244-7526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLERSON",
        "first_name": "CORAH",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0110009563",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110009563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fishersville, VA · Medical Physician Assistant in Virginia