Frederick W Tillman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000968 Issued in GA

Practice address

806 Dixie St
Carrollton, GA 30117-4416

Phone

(770) 834-2071

Fax

(770) 834-1007

NPI assigned

Nov 8, 2006

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 GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Rincon, GA
  • NPI 1437294592
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Tyrone, GA
  • NPI 1275326571
  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Bremen, GA
  • NPI 1376114488
  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Woodstock, GA
  • NPI 1144684184
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1902976061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174416",
            "telephone_number": "770-834-2071",
            "fax_number": "770-834-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "FREDERICK",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000233593B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bre'Andria Kamille Thompson, PA-C
• Kelly R Thompson, N.P.
• Trey B Thompson, PHARMD
• Lashondra T Thurman-Smart
• Caitlin Mehalick Tierney, D.O.
• TLC of Georgia LLC
• TMC Carousel Pediatrics Inc
• TMC Carrollton Family Healthcare, Inc
• TMC Children'S Healthcare of West Georgia
• TMC Home Health Inc

• Optometrist in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.