Amanda G Tidwell (NPI# 1831676840, PAC ID# 3274879309) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1831676840 |
| PAC ID by PECOS | 3274879309 |
| Professional Enrollment ID | I20190110003188 |
| Full Name | Amanda G Tidwell |
| Organization Legal Name | PERRY COUNTY MEDICAL CENTER INC |
| Address |
7723 Clearview Church Ln Lyles TN 37098-1674 |
| Phone Number | 9316705520 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4981706330 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440046 | TRISTAR HORIZON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 7723 Clearview Church Ln, Lyles, TN 37098-1674 | 9316705520 | PERRY COUNTY MEDICAL CENTER INC |
| Organization Legal Name | PERRY COUNTY MEDICAL CENTER INC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle Voss | Nurse Practitioner | Perry County Medical Center Inc | 7723 Clearview Church Ln, Lyles, TN 37098-1674 |
| Pamela C Brunson | Nurse Practitioner | Perry County Medical Center Inc | 115 E Brooklyn St, Linden, TN 37096-3515 |
| Vivian Reeves Stokes | Nurse Practitioner | Perry County Medical Center Inc | 115 E Brooklyn St, Linden, TN 37096-3515 |
| Sherry L Tidwell | Nurse Practitioner | Perry County Medical Center Inc | 115 E Brooklyn St, Linden, TN 37096-3515 |
| Kristy R King | Nurse Practitioner | Perry County Medical Center Inc | 115 E Brooklyn St, Linden, TN 37096-3515 |
| Jeffrey G Smith | Family Medicine | Perry County Medical Center Inc | 115 E Brooklyn St, Linden, TN 37096-3515 |
| Street Address |
7723 CLEARVIEW CHURCH LN |
| City | LYLES |
| State | TN |
| Zip | 37098-1674 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle Voss | Nurse Practitioner | Perry County Medical Center Inc | 7723 Clearview Church Ln, Lyles, TN 37098-1674 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen Mcclellan | Physical Therapy | 5194 Hwy 100, Suite 105, Lyles, TN 37098 |
| City | LYLES |
| Zip Code | 37098 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LYLES + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.