Nicole Marie Tillman, MACCC-SLP
NPI 1780065235ActiveIndividual· Speech-Language Pathologist· Cape Girardeau, MO
Speech-Language Pathologist (MACCC-SLP) with Powerback Rehabilitation LLC and 1 other group, practicing in Cape Girardeau, Missouri. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1780065235 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MACCC-SLP |
| Sole proprietor | No |
| NPI issued | Jun 10, 2015 |
| Last updated in NPPES | Oct 18, 2021 |
| Certified by provider | Oct 18, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 2009013299 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (MO) |
|---|
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
Medical groups
- Powerback Rehabilitation LLCJackson, MI · 649 clinicians
- Synergy Care Southeast LLCFort Worth, TX · 199 clinicians
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All 78 speech-language pathologists in Cape Girardeau · All speech-language pathologists in Missouri