Elton James Tidwell, DPT
Individual provider Active NPI Physical Therapist · Rockwood, TN
NPI 1174036065 · NPPES record last updated Aug 13, 2026
Key facts
- NPI
- 1174036065
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- CP060291T (CO)
- Practice address
- 1124 N Gateway Ave Ste 3
Rockwood, TN 37854-4214 - Phone
- (865) 882-9183
- NPI assigned
- Nov 14, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Agilitas USA, Inc
Practice addresses (Care Compare)
115 Cumberland PLZ
Crossville, TN 38555-4292
Phone (931) 787-1244
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180102002633 | TN | Practitioner - Physical Therapist in Private Practice | 5193083715 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11558 | TN | MD | Social Worker |
| CP053876T | MD | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agilitas USA, Inc | Current |
Accepting new patients | |
| Functional Pathways Preferred of Tennessee LLC | Physical Therapist | Current |
Accepting new patients |
| Results-Ast JV, LLC | Physical Therapist | Current |
Accepting new patients |
| Agilitas USA Inc | Physical Therapist | Current | Accepting new patients |
| Fox Rehabilitation Services TN LLC | Physical Therapist | Current |
Accepting new patients |
| Independent Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Agilitas USA, Inc | Physical Therapist | Current |
Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192
115 Cumberland Plz
Crossville, TN 38555
Phone (931) 787-1244
3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444
8904 Cross Park Dr
Knoxville, TN 37923
Phone (865) 558-6484
7688 Oak Ridge Hwy
Knoxville, TN 37931
Phone (865) 313-2865
10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847
8905 Town and Country Cir
Ste 9
Knoxville, TN 37923
Phone (865) 529-9185
820 Scenic Hwy
Ste B
Lookout Mtn, TN 37350
Phone (423) 825-1393
5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630
8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923
1124 N Gateway Ave
Ste 3
Rockwood, TN 37854
Phone (865) 882-9183
3056 Miles Johnson Pkwy
Spring Hill, TN 37174
Phone (931) 451-0009
2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11558 | TN | |
| Physical Therapist | 225100000X | CP060667T | AZ | |
| Physical Therapist | 225100000X | CP060291T | CO | Yes |
Addresses
Primary practice location
1124 N Gateway Ave Ste 3
Rockwood, TN 37854-4214
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217
Other practice location 1
8905 Town and Country Cir Ste 9
Knoxville, TN 37923-4931
Phone (856) 539-9185
Other practice location 2
115 Cumberland Plz
Crossville, TN 38555-4292
Phone (931) 787-1244
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler | Other | Fox Rehabilitation Services TN LLC |
Other providers in Rockwood, TN
- Lois Ann Smith
- Solid Rock RX Inc
- State of Tennessee
- Haveyn Cheyenne Stooksbury
- Summit Medical Group, PLLC
- Timbre LLC
- Ashley Underwood
- Victorian Square, LLC
- Wal-Mart Stores East LP
- Wal-Mart Stores East, LP
All providers in Rockwood, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.