Kelli D Tidwell, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN0000007947 Issued in TN

Practice address

1450 Dowell Springs Blvd
Suite 300
Knoxville, TN 37909

Phone

(865) 637-8812

Fax

(865) 637-8865

NPI assigned

Sep 6, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endocrinology Consultants of East TNGroup PAC ID 1951371525, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Health System, Inc Hospital, Knoxville, TN, CCN 440015

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Endocrinology Consultants of East TN

  • Endocrinology, Diabetes & Metabolism Physician
  • Knoxville, TN
  • NPI 1730395104
  Medicare reassignment Care Compare group NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Health System, Inc.

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1538164090
  Care Compare affiliation

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

{
    "created_epoch": "1220659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1104074822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 DOWELL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-637-8812",
            "fax_number": "865-637-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 DOWELL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-637-8812",
            "fax_number": "865-637-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "KELLI",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-06",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000007947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005786",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Tibben, AGPCNP
• Mark Tichon, PSYCHOLOGIST/HSP
• Paul Timothy Tidmore, NP
• Christy Love Tidwell, CRNA
• Kara Tidwell, RBT
• Robyn Marie Tidwell
• Edward B Tieng, M.D.
• James Matthew Tignor, PA-C
• Kelsee R Tignor, PHARMD
• Matthew Aaron Tillery, BS

• Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.