TILLMAN MEDICAL GROUP PA
NPI 1043260615
Specialist in Vidalia, LA
About Tillman Medical Group Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TILLMAN MEDICAL GROUP PA (NPI 1043260615) is a healthcare organization registered as a specialist in Vidalia, Louisiana and active in the NPI registry since May 2006. The organization lists Tana L Archer, Accounts Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tillman Medical Group Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Tillman Medical Group PA, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Tillman Medical Group PA's NPI number?
The NPI number for Tillman Medical Group PA is 1043260615. It was assigned to this organization in the NPPES registry on May 12, 2006.
Where is Tillman Medical Group PA located?
Tillman Medical Group PA is located at 107 Front St, Vidalia, LA 71373. The listed phone number is (318) 336-2216.
What is Tillman Medical Group PA's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Tillman Medical Group PA enrolled in Medicare?
Yes. Tillman Medical Group PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tillman Medical Group PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Tillman Medical Group PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Tillman Medical Group PA was last updated on June 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.
# Tillman Medical Group Pa · NPI 1043260615
Specialist organization in Vidalia, Louisiana. Organization record, active in the CMS NPPES registry since May 12, 2006.
## Identity
- **NPI:** 1043260615 (Entity type: Organization)
- **Enumerated:** May 12, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Tana Archer, ACCOUNTS MANAGER
## Practice location
- **Address:** 107 FRONT ST, Vidalia, LA 71373-2836
- **Phone:** (318) 336-2216
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 4, 2013
- **Other identifiers:** Medicare ID-Type Unspecified 5D595 (LA)
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Source: [NPI Profile](https://npiprofile.com/npi/1043260615) · Data from the CMS NPPES public registry.