Shari Tillman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11007581 Issued in FL

Practice address

375 S Courtenay Pkwy Ste 4
Merritt Island, FL 32952-4868

Phone

(321) 544-0757

Fax

(321) 338-7062

NPI assigned

Jul 8, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unconditional Love Inc.Group PAC ID 4385679026, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
• Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stillman369779@adventhealth.direct-ci.com
• Direct secure messaging: shari.tillman.1@23524.direct.athenahealth.com

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.

• Unconditional Love Inc.

  • Clinic/Center
  • Melbourne, FL
  • NPI 1265455133
  Medicare reassignment Care Compare group NPD
• Tropical Family Healthcare, LLC

  • Family Medicine Physician
  • Merritt Island, FL
  • NPI 1467232900
  Medicare reassignment Authorized official
• Omni Healthcare, Inc.

  • Specialist
  • Melbourne, FL
  • NPI 1134191323
  Medicare reassignment NPD
• Launch Point Outreach

  • Family Nurse Practitioner
  • Merritt Island, FL
  • NPI 1417878067
  NPD (past) Authorized official

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

• Cape Canaveral Hospital, Inc.

  • General Acute Care Hospital
  • Cocoa Beach, FL
  • NPI 1184691610
  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1568080422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S COURTENAY PKWY STE 4",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524868",
            "telephone_number": "321-544-0757",
            "fax_number": "321-338-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S COURTENAY PKWY STE 4",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524868",
            "telephone_number": "321-544-0757",
            "fax_number": "321-338-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "SHARI",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "florida",
            "affiliation": "N",
            "address_1": "1510 Monte Carlo Ct",
            "city": "Merritt Island",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329525666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• San Htut Thiha, MD
• Jaquashia Thomas, MSW
• Tricia Thomas, CCC-SLP
• Thrive Home Therapy & Design
• Lee Paul Tibbitts Jr., RPH
• Lauren Timney, LMHC MS
• Caitlin Marie Tomlin
• Jennifer Torpy
• Jessica Toynbee
• Robert Walter Traven, D.C.

• Family Nurse Practitioner in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.