Miss Kenosha Latrice Tillman, NURSE PRACTITIONER - Medicare Nurse Practitioner in Fairburn, GA

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Miss Kenosha Latrice Tillman, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fairburn, Georgia. Her current practice location is 5220 Rosewood Pl, Fairburn, Georgia. You can reach out to her office (for appointments etc.) via phone at (901) 277-7086.

Miss Kenosha Latrice Tillman is licensed to practice in Georgia (license number GAA-NP000960) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1275886103.

Contact Information

Miss Kenosha Latrice Tillman, NURSE PRACTITIONER
5220 Rosewood Pl,
Fairburn, GA 30213-5113
(901) 277-7086
Not Available

Map and Direction




Provider's Profile

Full NameMiss Kenosha Latrice Tillman
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location5220 Rosewood Pl, Fairburn, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275886103
  • Provider Enumeration Date: 10/16/2012
  • Last Update Date: 11/07/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6709249246
  • Enrollment ID: I20230830003310

Medical Identifiers

Medical identifiers for Miss Kenosha Latrice Tillman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275886103NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health GAA-NP000960 (Georgia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Miss Kenosha Latrice Tillman allows following entities to bill medicare on her behalf.
Entity NameInner Community Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891398541
PECOS PAC ID: 8729441852
Enrollment ID: O20230823000046

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Kenosha Latrice Tillman is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Miss Kenosha Latrice Tillman, NURSE PRACTITIONER
5220 Rosewood Pl,
Fairburn, GA 30213-5113

Ph: () -		Miss Kenosha Latrice Tillman, NURSE PRACTITIONER
5220 Rosewood Pl,
Fairburn, GA 30213-5113

Ph: (901) 277-7086

Reviews and Comments


Nurse Practitioner Nurses in Fairburn, GA

Ms. Monica Smart Mills,
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Practice Location: 8315 Champion Trl, Fairburn, GA 30213
Phone: 770-892-7878    
Mrs. Nicole Michelle Boone, NP-C
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Phone: 770-716-8781    
Melanie Kline, FNP-BC, AGACNP-BC
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Practice Location: 3782 Oakman Pl, Fairburn, GA 30213
Phone: 860-836-7236    
Ms. Felisha Nicole Tune, NP
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Medicare: Medicare Enrolled
Practice Location: 2218 Jenny Dr, Fairburn, GA 30213
Phone: 252-639-0409    
Ms. Jacquelyn Pressley,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 5185 Rosewood Pl, Fairburn, GA 30213
Phone: 770-990-2936    
Nicolette Semple,
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Medicare: Not Enrolled in Medicare
Practice Location: 670 Breton Highlands, Fairburn, GA 30213
Phone: 347-844-2856    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.