NPIMap

Individual provider Active NPI

James Bradley Tilley, M.D.

  • General Practice Physician
  • Conway, AR
National Provider Identifier
1932178332
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
E-2822 Issued in AR
Practice address
495 Hogan Rd, Ste 1
Conway, AR 72034
Phone
(501) 327-1150
Fax
(501) 327-3427
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X E-2822 AR Primary

Addresses

Primary practice location

495 Hogan Rd, Ste 1
Conway, AR 72034

Mailing address

495 Hogan Rd, Ste 1
Conway, AR 72034
Phone (501) 327-1150

Other identifiers 1

IdentifierTypeStateIssuer
146509001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803001299 AR Practitioner - Family PracticePractitioner - Hospice/Palliative Care 4385606375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
University of Arkansas College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tilley Family Medicine PAGroup PAC ID 8224012505, 4 clinicians

Practice addresses (Care Compare)

495 Hogan LN
Suite 1
Conway, AR 72034-8498
Phone (501) 327-1150

Hospital & facility affiliations

  • Conway Regional Homecare SVCS Home health agency, Conway, AR, CCN 047083
  • Elite Home Health Home health agency, Little Rock, AR, CCN 047028
  • Gentiva Hospice, Little Rock, AR, CCN 041561
  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029
  • CHI St Vincent Morrilton Hospital, Morrilton, AR, CCN 041324
  • Baptist Health Medical Center- Conway Hospital, Conway, AR, CCN 040154
  • Perry County Nursing and Rehabilitation Center Nursing home, Perryville, AR, CCN 045246

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tilley Family Medicine, PA CurrentSince Jul 2, 2002 Accepting new patients

Locations

495 Hogan Ln
Ste 1
Conway, AR 72034
Phone (501) 327-1150

1321 Scenic Dr
Perryville, AR 72126
Phone (501) 889-2400

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Perry County Nursing and Rehabilitation CenterPerryville, AR, CCN 045246 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 10, 2024
Dec 10, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

Hospital & facility affiliations 12

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1932178332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 HOGAN RD, STE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-327-1150",
            "fax_number": "501-327-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HOGAN RD, STE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-327-1150",
            "fax_number": "501-327-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "JAMES",
        "middle_name": "BRADLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "E-2822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146509001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.