IVY TIDWELL PROTHRO (NPI# 1811529381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811529381 |
| Entity Type | Individual |
| Full Name | IVY TIDWELL PROTHRO |
| Credential | FNP-BC |
| Practice Address |
4701 Sangamore Rd Ste S207 Bethesda MD 20816-2529 |
| Practice Telephone | 2026847176 |
| Mailing Telephone | 2026847167 |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R241507 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4701 SANGAMORE RD STE S207 |
| City | BETHESDA |
| State | MD |
| Zip Code | 20816-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609030022 | Abigail S Burke | Nurse Practitioner | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2008-07-15 |
| 1467051409 | Ggskinlaserhair | Nurse Practitioner | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2020-10-21 |
| 1194335919 | Samantha Perry | Nurse Practitioner | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2020-08-06 |
| 1811536568 | Carolyn Brown | Family Medicine | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2019-12-29 |
| 1659852580 | Kelly Care, LLC | Nurse Practitioner | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2018-08-28 |
| 1548690639 | Lisa Lindstrom | Nurse Practitioner | 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 | 2013-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881257756 | Marie Theresa Newman | Registered Nurse | 6211 Winnebago Road, Bethesda, MD 20816 | 2019-04-17 |
| 1336695600 | Corewood Care LLC | In Home Supportive Care | 4701 Sangamore Rd Ste S225, Bethesda, MD 20816 | 2016-08-28 |
| 1184077786 | Bobby Mann | Dentist | 4701 Sangamore Rd Ste 250, Bethesda, MD 20816 | 2016-07-19 |
| 1538572755 | Bethesda-chevy Chase Assessment and Counseling Associates | Social Worker | 4701 Sangamore Rd., #s235, Bethesda, MD 20816 | 2014-06-05 |
| 1982022430 | Kate Poropatich | Student in an Organized Health Care Education/Training Program | 5710 Springfield Dr., Bethesda, MD 20816 | 2014-04-02 |
| 1134567373 | Edwin Gordon | Specialist | 5821 Osceola Rd, Bethesda, MD 20816 | 2013-06-10 |
| 1336470335 | Robin Andrea Ely | Family Medicine | 4633 River Road, Bethesda, MD 20816 | 2010-01-15 |
| 1861630220 | Cheryl Sladkin Altschuler | Pediatrics | 7307 Macarthur Blvd, Suite 200, Bethesda, MD 20816 | 2009-01-22 |
| 1689869323 | Monroe Pray Jr. | Psychiatry & Neurology | 4915 Earlston Dr, Bethesda, MD 20816 | 2007-09-06 |
| 1154426989 | Maryland Cvs Pharmacy LLC | Pharmacy | 4601a Sangamore Rd, Bethesda, MD 20816 | 2006-09-14 |
| Find all providers in zip 20816 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365082 | Chibuzor Susan Igolo | Nurse Practitioner | 4494 N Palmer Rd N, Bethesda, MD 20814 | 2020-10-26 |
| 1407454671 | Yasamin Baghaipour | Nurse Practitioner | 10115 Parkwood Dr, Bethesda, MD 20814-4033 | 2020-10-11 |
| 1174132682 | Touko Leuga | Nurse Practitioner | 6410 Rockledge Dr Ste 110, Bethesda, MD 20817-1825 | 2020-07-30 |
| 1073170346 | Tonya Lynn Jenkins | Nurse Practitioner | 10 Center Drive 3ne, Bethesda, MD 20892-0001 | 2019-05-22 |
| 1366909848 | Crystal Flowers | Nurse Practitioner | Bg 10-crc Rm 1-3750, 10 Center Dr, Bethesda, MD 20814 | 2019-02-21 |
| 1043718653 | Mahsa Motevalli | Nurse Practitioner | 8600 Old Georgetown Rd Fl 6, Bethesda, MD 20814 | 2018-01-29 |
| 1558806778 | Keshia C Thompson | Nurse Practitioner | National Institutes of Health Building 10, Room 2c145, Bethesda, MD 20892-1662 | 2016-12-23 |
| 1083160402 | Britanny Brooke Solarz | Nurse Practitioner | 10 Center Drive Building 10 2b46, Bethesda, MD 20892-0001 | 2016-08-26 |
| 1710333281 | Deirdre Fionna Angelastro | Nurse Practitioner | 4938 Saint Elmo Ave, Bethesda, MD 20814-6008 | 2016-05-13 |
| 1902262447 | Relia Atienza | Nurse Practitioner | National Institute of Br, 10 Center Drive, Bethesda, MD 20892-0001 | 2016-01-13 |
| Find all providers in BETHESDA | ||||
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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.