Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Shadrick Wyatt Tillotson, PMHNP-BC

Individual provider Family Nurse Practitioner · NPI 1528514809

Mr. Shadrick Wyatt Tillotson, PMHNP-BC is a Nurse Practitioner in Lehi, Utah. Qualified in 2015, 11 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
11
Licensed in
UT
In the registry since
2016
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

2901 W Blue Grass Blvd Ste 200
Lehi, UT 84043-4190
Phone: (385) 510-5150
Fax: (866) 748-5235
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 6223314-4405 (UT)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 6223314-4405 (UT)

Record details

NPI number1528514809
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedAugust 28, 2016
Last updated in NPPESApril 2, 2024
Certification dateApril 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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