Kayla Kizziah Tidwell, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-145314 Issued in AL

Practice address

3316 Highway 280
Alexander City, AL 35010-3369

Phone

(256) 329-7100

NPI assigned

Apr 9, 2018

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 names 1

• Miss Kayla Danielle Kizziah Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Russell Hospital CorporationGroup PAC ID 6406754431, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Troy, AL, CCN 017324
• Russell Medical Center Hospital, Alexander City, AL, CCN 010065
• The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029

Merit-based Incentive Payment System (MIPS)

Final score

71.09 of 100Reported as group

Quality

52.05

Promoting interoperability

80

Improvement activities

40

Cost

68.25

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Russell Hospital Corporation

  dba Russell Medical Center

  • General Acute Care Hospital
  • Alexander City, AL
  • NPI 1811913460
  Medicare reassignment Care Compare group NPD
• Russell Hospital Corporation

  dba Medical Park Family Care

  • Rural Health Clinic/Center
  • Dadeville, AL
  • NPI 1215953799
  NPD
• Russell Hospital Corporation

  • Rural Health Clinic/Center
  • New Site, AL
  • NPI 1700419868
  NPD

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

• Eh Health Home Health of Alabama, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Troy, AL
  • NPI 1366904161
  Care Compare affiliation
• Russell Hospital Corporation

  dba Russell Medical Center

  • General Acute Care Hospital
  • Alexander City, AL
  • NPI 1811913460
  Care Compare affiliation
• The East Alabama Health Care Authority

  dba East Alabama Medical Center

  • General Acute Care Hospital
  • Opelika, AL
  • NPI 1154386431
  Care Compare affiliation

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608940800000",
    "number": "1174020929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S TALLASSEE ST",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368531844",
            "telephone_number": "256-825-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 HIGHWAY 280",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350103369",
            "telephone_number": "256-329-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "KAYLA",
        "middle_name": "KIZZIAH",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2020-12-26",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-145314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkizziah@russellmedcenter.com",
            "affiliation": "N",
            "address_1": "3316 Highway 280",
            "city": "Alexander City",
            "state": "AL",
            "country_code": "US",
            "postal_code": "350103369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "KIZZIAH",
            "middle_name": "DANIELLE",
            "prefix": "MISS",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Alexander City, AL
• Providers in Alexander City, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2020; 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.