JOHN EDWARD TIDWELL (NPI# 1184885519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184885519 |
| Entity Type | Individual |
| Full Name | JOHN EDWARD TIDWELL |
| Credential | MD |
| Practice Address |
729 N Medical Center Dr W Suite 111 Clovis CA 93611-6879 |
| Mailing Address |
2625 E Divisadero St Fresno CA 93721-1431 |
| Practice Telephone | 5593200531 |
| Practice Fax Number | 5593200539 |
| Mailing Telephone | 5594432682 |
| Mailing Fax Number | 5594432681 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2015-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | A137400 | CA | Allopathic & Osteopathic Physicians |
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
A137400 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003906835 | John K. Tidwell | Dentist | 1801 Nw Market St, Suite 108, Seattle, WA 98107-3987 | 2006-10-13 |
| 1790781805 | John W. Tidwell II | Obstetrics & Gynecology | 2801 Randolph Rd, Ste 200, Charlotte, NC 28211-1051 | 2005-06-23 |
| Street Address |
729 N MEDICAL CENTER DR W SUITE 111 |
| City | CLOVIS |
| State | CA |
| Zip Code | 93611-6879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881762896 | Eric L Pagenkopf | Orthopaedic Surgery | 729 N Medical Center Dr W, Suite 111, Clovis, CA 93611-6879 | 2006-11-30 |
| 1841727658 | Sirvard M Kaptryan | Nurse Practitioner | 729 N Medical Center Dr W, 101, Clovis, CA 93611-6879 | 2017-05-11 |
| 1598155202 | Elizabeth Aurea May | Physician Assistant | 729 N Medical Center Dr W, Suite 111, Clovis, CA 93611-6879 | 2015-02-02 |
| 1528468501 | Tawne Fishback | Nurse Practitioner | 729 N Medical Center Dr W, Clovis, CA 93611-6879 | 2014-08-27 |
| 1538574660 | Clovis Pediatric Group | Pediatrics | 729 N Medical Center Dr W, 201, Clovis, CA 93611-6879 | 2014-06-26 |
| 1740613041 | Joshua Paul Lazarus | Physician Assistant | 729 N Medical Center Dr W, Clovis, CA 93611-6879 | 2013-08-10 |
| 1326237629 | Christine Marie Card | Nurse Practitioner | 729 N Medical Center Dr W, Suite 205, Clovis, CA 93611-6879 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773122 | Mao Thao | Pharmacist | 2133 Shaw Avenue, Clovis, CA 93611 | 2019-04-24 |
| 1326506098 | Lauren Moriah Horsley | Speech-Language Pathologist | 650 W. Alluvial Ave., Clovis, CA 93611 | 2019-03-12 |
| 1780171223 | Alamos Care | Skilled Nursing Facility | 2193 Alamos Ave, Clovis, CA 93611 | 2018-04-19 |
| 1346612215 | Aimee Rasch | Occupational Therapy Assistant | 650 West Alluvial Avenue, Clovis, CA 93611 | 2015-10-30 |
| 1356778302 | Jonathan Crosby | Physician Assistant | 729 N Medical Center Drive West Suite 101, Clovis, CA 93611 | 2013-10-07 |
| 1093142697 | Stacey Melissa Montes | Nurse Practitioner | 729 N Medical Ctr Dr West, Suite 205, Clovis, CA 93611 | 2013-09-27 |
| 1538594163 | Carly Bren Lepp | Physician Assistant | 2006 Shaw Avenue, Clovis, CA 93611 | 2013-09-13 |
| 1811246150 | Vishal Arya | Pharmacist | 2518 Austin Ave, Clovis, CA 93611 | 2012-08-31 |
| 1669757209 | Kiran V Atwal | Pharmacist | 1815 Herndon Ave--walgreens, Clovis, CA 93611 | 2011-10-14 |
| 1952615957 | Weight Away | Nutritionist | 1895 Herndon Ave, Suite 105, Clovis, CA 93611 | 2010-08-02 |
| Find all providers in zip 93611 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835131 | Jacob Matz | Orthopaedic Surgery | Orthopaedic Trauma Institute, 2550 23rd St Building 9, 2nd Floor, San Francisco, CA 94110 | 2019-08-03 |
| 1609219658 | Matthew John Herring | Orthopaedic Surgery | Ucsf Orthopaedic Trauma Institute, 2550 23rd St., Bldg. 9, 2nd Floor, San Francisco, CA 94110 | 2013-04-09 |
| 1609038256 | Vahdatyar Amirpour M.d. Inc | Orthopaedic Surgery | 2501 H St, Bakersfield, CA 93301-2817 | 2008-06-25 |
| 1639336076 | Christian Seaholm Bromfield | Orthopaedic Surgery | 6600 Bruceville Rd Ste 111, Sacramento, CA 95823-4671 | 2008-05-22 |
| 1629255237 | David C Chang | Orthopaedic Surgery | 307 Placentia Ave., Suite # 111, Newport Beach, CA 92663 | 2008-01-25 |
| 1881881431 | Christopher Max Hoshino | Orthopaedic Surgery | 1000 W Carson St # 422, Torrance, CA 90502-2004 | 2007-09-27 |
| 1487840583 | John H. Serocki, Md, Apc | Orthopaedic Surgery | 9834 Genesee Ave #228, La Jolla, CA 92037 | 2007-09-21 |
| 1144300385 | Gary Jack Phipps | Orthopaedic Surgery | 26720 Crown Valley Parkway, Suite 200, Mission Viejo, CA 92691 | 2006-10-16 |
| 1013024926 | Aaron G. Osborne, D.o., Inc. | Orthopaedic Surgery | 2480 Sonoma St, Redding, CA 96001-3027 | 2006-08-24 |
| 1689689176 | Lorra Marie Sharp | Orthopaedic Surgery | 1955 Citracado Pkwy Ste 200, Escondido, CA 92029-4112 | 2006-07-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.