LOGAN BROOKE TILLMAN FNP
NPI 1023987690
Nurse Practitioner - Family in Baxley, GA

Q: What is Logan Tillman's NPI number?

The NPI number for Logan Tillman is 1023987690. It was assigned to this individual provider in the NPPES registry on November 3, 2025.

Q: What is Logan Tillman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Logan Tillman was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 03, 2025PECOS Enrolled

105 E TOLLISON ST, BAXLEY, GA 31513(912) 367-0102(912) 367-9966 Get Directions Write a Review

NPPES record last updated: June 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Logan Brooke Tillman Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOGAN BROOKE TILLMAN FNP (NPI 1023987690) is an individual family provider in Baxley, Georgia, licensed in Georgia (APRN-NP298425) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1023987690

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLOGAN BROOKE TILLMANCredential: FNP

Location Address105 E TOLLISON STBaxley, GA 31513-0149

Mailing Address5522 Ten Mile RdBaxley, GA 31513-6223 · (912) 367-0102 · Fax (912) 367-9966

Phone(912) 367-0102

Fax(912) 367-9966

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateNovember 3, 2025

Last NPPES UpdateJune 17, 2026

NPPES CertifiedJune 17, 2026

✔ NPI 1023987690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · APRN-NP298425

105 E TOLLISON ST, Baxley, GA 31513

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Logan Brooke Tillman Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2062907181

PECOS Enrollment IDI20251216004115

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31513 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THE BAXLEY & APPLING COUNTY HOSPITAL AUTHORITY

Clinic/Center (Rural Health)

105 E TOLLISON ST
BAXLEY, GA 31513

Appling County (912) 367-4122

SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC

Internal Medicine (Pulmonary Disease)

105 E TOLLISON ST, # A
BAXLEY, GA 31513

Appling County (912) 927-6270

MELANIE S YOUNG FNP

Nurse Practitioner (Family)

105 E TOLLISON ST, SUITE D
BAXLEY, GA 31513

Appling County (912) 366-9688

THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY

Clinic/Center (Rural Health)

105 E TOLLISON ST, SUITE D
BAXLEY, GA 31513

Appling County (912) 366-9688

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Logan Tillman's NPI number?

The NPI number for Logan Tillman is 1023987690. It was assigned to this individual provider in the NPPES registry on November 3, 2025.

Where is Logan Tillman located?

Logan Tillman practices at 105 E Tollison St, Baxley, GA 31513. The listed phone number is (912) 367-0102.

What is Logan Tillman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Logan Tillman enrolled in Medicare?

Yes. Logan Tillman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Logan Tillman was last updated on June 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.