Katie Tidwell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

J2-0000457 Issued in DE

Practice address

110 W North St
Georgetown, DE 19947-2144

Phone

(302) 856-4574

NPI assigned

Jun 3, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1023859238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28563 COLLINS FARM RD",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199661534",
            "telephone_number": "302-236-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W NORTH ST",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199472144",
            "telephone_number": "302-856-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "KATIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DE",
            "license": "J2-0000457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josie Thomas
• Latoya Thomas
• Romina M. Thomas, MD
• Thresholds, Inc.
• Tidalhealth Physician Network, Inc.
• Kathryn Ruth Tober, R.N.
• Ashley Marie Touchton, FNP
• Breanna Mackenzie Tovar-Diaz, RDN, LDN
• Kimberly A Trout
• Melissa Tyler, P.A.

• Physical Therapy Assistant in Georgetown, DE
• Providers in Georgetown, DE by specialty
• Physical Therapy Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.