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MS. CANDACE MARVENIA TILLMAN RNC, MS, WHNP-BC
NPI 1871865113
Nurse Practitioner - Adult Health in Conyers, GA

Active since February 02, 2012PECOS EnrolledAccepts Medicare Assignment
3230 OLD CHURCH CV NE, CONYERS, GA 30012(678) 221-8855 Get Directions Write a Review

NPPES record last updated: September 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Candace Marvenia Tillman Rnc, Ms, Whnp-bc NPPES

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

MS. CANDACE MARVENIA TILLMAN RNC, MS, WHNP-BC (NPI 1871865113) is an individual adult health provider in Conyers, Georgia, licensed in Georgia (RN142932) and active in the NPI registry since February 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1871865113
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMS. CANDACE MARVENIA TILLMANCredential: RNC, MS, WHNP-BC
Location Address3230 OLD CHURCH CV NEConyers, GA 30012-2647
Mailing Address3230 Old Church Cv NeConyers, GA 30012-2647 · (678) 221-8855
Phone(678) 221-8855
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateFebruary 2, 2012
Last NPPES UpdateSeptember 8, 2024
NPPES CertifiedSeptember 8, 2024
✔ NPI 1871865113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in GA · RN142932
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X · License RN142932 (GA)
3230 OLD CHURCH CV NE, Conyers, GA 30012
Open in Google Maps ↗

Other Identifiers 1

OtherRN142932GA · State Of Georgia

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Candace Marvenia Tillman Rnc, Ms, Whnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597901470
PECOS Enrollment IDI20130419000241
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Candace Tillman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vitality Ageless Center LLC
24 mi
Multi-Specialty
VITALITY AGELESS CENTER LLC, 1300 PEACHTREE INDUSTRIAL BLVD #1201
Suwanee, GA 30024
  • Reassigned Medicare billing, Georgia enrollment
  • 8 clinicians in this Medicare group
NPI 1730657271 (770) 614-6266
Vpa PC
26 mi
Family Medicine
3400 PEACHTREE RD NE STE 1250
Atlanta, GA 30326
  • Reassigned Medicare billing, Georgia enrollment
  • 100 clinicians in this Medicare group
NPI 1164149365 (470) 964-1700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30012 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

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 Candace Tillman's NPI number?

The NPI number for Candace Tillman is 1871865113. It was assigned to this individual provider in the NPPES registry on February 2, 2012.

Where is Candace Tillman located?

Candace Tillman practices at 3230 Old Church Cv NE, Conyers, GA 30012. The listed phone number is (678) 221-8855.

What is Candace Tillman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Candace Tillman enrolled in Medicare?

Yes. Candace Tillman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Candace Tillman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Candace Tillman reassigns Medicare benefits to 2 organizations: Vitality Ageless Center LLC (Suwanee, GA) and Vpa PC (Atlanta, GA). Each 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 Candace Tillman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Candace Tillman was last updated on September 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.