Individual provider Active NPI

Erika Minerva Tidwell, PMHNP-BC, FNP-C

  • Family Nurse Practitioner
  • Harlingen, TX
National Provider Identifier
1184190456
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138944 Issued in TX
Practice address
512 Victoria LN Ste 14
Harlingen, TX 78550-3235
Phone
(956) 365-4400
Fax
(956) 365-4111
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138944 TX Primary

Addresses

Primary practice location

512 Victoria LN Ste 14
Harlingen, TX 78550-3235

Mailing address

512 Victoria LN Ste 2
Harlingen, TX 78550-3227
Phone (956) 365-4400

Other practice location 1

4211 N Jackson Rd
McAllen, TX 78504-6843
Phone (956) 365-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20231229002294 TX Practitioner - Nurse Practitioner 6901256171 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Consultants of South Texas, PLLCGroup PAC ID 3274624937, 42 clinicians

Practice addresses (Care Compare)

512 Victoria LN
Suite 14
Harlingen, TX 78550-3235
Phone (956) 412-0055

720 N 77 Sunshinestrip
Harlingen, TX 78550-8848
Phone (956) 365-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1184190456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN STE 2",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503227",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN STE 14",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503235",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 N Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785046843",
            "country_code": "US",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "ERIKA",
        "middle_name": "MINERVA",
        "credential": "PMHNP-BC, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.