Tony Maurice Tidwell

Primary specialty

Transportation Network CompanyTaxonomy code 342000000X

License

27832707 Issued in NC

Practice address

4503 Devonhill LN
Charlotte, NC 28269-4077

Phone

(980) 215-3027

NPI assigned

Jun 5, 2022

Sex

Male

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

State licenses

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

{
    "created_epoch": "1654387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1134858301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4503 DEVONHILL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694077",
            "telephone_number": "980-215-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 DEVONHILL LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282694077",
            "telephone_number": "980-215-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "TONY",
        "middle_name": "MAURICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-05",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": "NC",
            "license": "27832707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Griffirth Tice, MA, LPC, NCC, CCAS
• Delaney Marie Tice
• Michelle Louise Tidd, PA
• Heather Tidwell, LCSW
• John W. Tidwell II, MD
• Daniel J. Tierney, MD
• Ties That Bind Mental Health LLC
• Tiffani'S Comfort Care
• Tiffany Austin Counseling PLLC
• Tiffany Franklin

• Transportation Network Company in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Transportation Network Company in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; 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.