Andrea Marie Tidd, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

NPI1073873048

Practice address

NBHC Portsmouth
402 Goodrich Ave
Kittery, ME 03904

Phone

(603) 430-2430

NPI assigned

May 23, 2012

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1073873048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 80 BOX 13414",
            "city": "APO",
            "state": "AP",
            "postal_code": "963670037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NBHC PORTSMOUTH",
            "address_2": "402 GOODRICH AVE",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "03904",
            "telephone_number": "603-430-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDD",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "NPI1073873048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Stout, LADC
• Tammy Paulus Svenson, LICSW
• Stephen T. Swallow, DDS
• Eileen Sweeney, LMSWCC
• Victoria Theroux, PA-C
• Timothy Kingsbury D O Inc
• Kenneth Boyd Tolman, PA-C
• Town of Kittery
• Town of Kittery
• Stewart James Turner, MD

• Physician Assistant in Kittery, ME
• Providers in Kittery, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.