LAUREN BLAIR TIDWELL (NPI# 1497204002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497204002 |
| Entity Type | Individual |
| Full Name | LAUREN BLAIR TIDWELL |
| Credential | PA-C |
| Practice Address |
104 Spenryn Dr Madison AL 35758-1890 |
| Mailing Address |
117 Clubhouse Ln Madison AL 35757-6934 |
| Practice Telephone | 2567724300 |
| Mailing Telephone | (256) 426-0683 |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA.1163 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Browns Ferry Rd, Madison, AL 357589601 | 2564617272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942823620 | Lauren Michelle Tidwell | Psychologist | 1601 Sw Archer Rd # 116b, Gainesville, FL 32608-1135 | 2020-05-28 |
| 1568719334 | Lauren Elizabeth Tidwell | Nurse Anesthetist, Certified Registered | 500 J Clyde Morris Boulevard, Newport News, VA 23601-1929 | 2012-08-10 |
| Street Address |
104 SPENRYN DR |
| City | MADISON |
| State | AL |
| Zip Code | 35758-1890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871863050 | Patrick J Oneill M.d., P.C. | Clinic/Center | 104 Spenryn Dr, Madison, AL 35758-1890 | 2012-01-05 |
| 1639631328 | Lindsey Page Guill | Physician Assistant | 104 Spenryn Dr, Madison, AL 35758-1890 | 2019-04-02 |
| 1356870398 | Panacea O'neill Medical Group Inc | Family Medicine | 104 Spenryn Dr, Madison, AL 35758-1890 | 2017-06-05 |
| 1003357195 | Kealan O'neill I | Family Medicine | 104 Spenryn Dr, Madison, AL 35758-1890 | 2017-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487299277 | Hanging Lanes Christian Wellness Ministries and Counseling Center | Counselor | 650 Sun Temple Drive, Madison, AL 35758 | 2019-11-15 |
| 1104487396 | Caroline Thomas Estes | Occupational Therapist | 8475 Wann Drive, Madison, AL 35758 | 2019-06-27 |
| 1265902894 | Sharinne Summers Sears | Registered Nurse | 204 Grove Village Way, Madison, AL 35758 | 2018-11-27 |
| 1013484666 | Lori Pohly | Counselor | 190 Lime Quarry Road, Suite 212, Madison, AL 35758 | 2018-10-31 |
| 1174022297 | Rhonda Marie Stalb | Marriage & Family Therapist | 650 Sun Temple Dr Ste 101, Madison, AL 35758 | 2018-02-04 |
| 1528585932 | Alabama Dental Professionals, PC | Dentist | 7666 Highway 72 W, Madison, AL 35758 | 2017-08-25 |
| 1134658537 | Diane Bierbauer | Dietitian, Registered | 520 Thoreau Spring Ct, Madison, AL 35758 | 2017-06-08 |
| 1255870408 | Maggie Collins | Nurse Practitioner | 7559 U.S. 72, Madison, AL 35758 | 2017-02-21 |
| 1649648858 | Terry A. Burgess | Dentist | 810 Palmer Plaza, # 103, Madison, AL 35758 | 2015-09-03 |
| 1063896314 | Caswall C Harrigan Physician PC | Family Medicine | Madison Medical Plaza 540 Hughes Road, Suite 14, Madison, AL 35758 | 2015-07-16 |
| Find all providers in zip 35758 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962804211 | Miranda Street Sudduth | Physician Assistant | 1607 Doctors Drive, Madison, MS 39110 | 2014-09-18 |
| 1184944068 | Thomas Harvey Greene IIi | Physician Assistant | 248 Ne Hancock Ave, Madison, FL 32340-2560 | 2010-06-02 |
| 1699001735 | Chad Jamison Gilliam | Physician Assistant | 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 | 2009-10-24 |
| 1679763700 | Tamara A Melone | Physician Assistant | 2802 International Lane, Madison, WI 53708-0017 | 2007-07-25 |
| 1932237138 | Craig Michael Roberts | Physician Assistant | 2631 Chamberlain Ave, Madison, WI 53705-3717 | 2007-03-01 |
| 1639234610 | Sally-ann P Johannsen | Physician Assistant | 717 Hidden Cave Rd, Madison, WI 53717-2755 | 2006-12-27 |
| 1023105467 | Nicole Anna Hanson | Physician Assistant | 1617 Sherman Avenue, Madison, WI 53708-0017 | 2006-10-06 |
| 1730137548 | Renee A Knutson | Physician Assistant | 38 Hidden Hollow Trl, Madison, WI 53717-2501 | 2006-05-04 |
| 1669439329 | Deanna J Nakada | Physician Assistant | 750 University Row, Madison, WI 53705-1311 | 2006-04-27 |
| 1326002213 | Angela K Vitcenda | Physician Assistant | 701 Dane Street, Madison, WI 53713 | 2006-04-17 |
| Find all providers in MADISON | ||||
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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.