Amber Rachelle Tillman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5018651 Issued in NC

Practice address

760C NW Broad St
Southern Pines, NC 28387-4102

Phone

(916) 431-0236

Fax

(855) 259-0680

NPI assigned

Aug 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2025 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

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.

• Fortified Med PLLC

  • Primary Care Clinic/Center
  • Southern Pines, NC
  • NPI 1174204879
  NPD
• Thrive Health & Wellness, Inc.

  • Clinic/Center
  • Southern Pines, NC
  • NPI 1497337513
  NPD
• Pinehurst Medical Clinic, Inc.

  • Clinical Medical Laboratory
  • Southern Pines, NC
  • NPI 1962509372
  NPD (past)

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1942083365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760C NW BROAD ST",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283874102",
            "telephone_number": "916-431-0236",
            "fax_number": "855-259-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760C NW BROAD ST",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283874102",
            "telephone_number": "916-431-0236",
            "fax_number": "855-259-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "AMBER",
        "middle_name": "RACHELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5018651",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NC",
            "license": "5018651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Brian Thompson, FNP
• Thrive Health & Wellness, Inc.
• David Brennen Throneburg, OD
• John Thomas Tierney, DC
• Karen Tiller, COTA
• Mercedes Timmons
• Katherine Tinker, LPA
• Jessica Tippit, DPT
• TLH - Cap Services
• Madison Todd

• Family Nurse Practitioner in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.