Pat Thomas Tidwell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME30890 Issued in FL

Practice address

4400 E Highway 20 Ste 203
Niceville, FL 32578-7700

Phone

(850) 897-3678

Fax

(850) 373-4544

NPI assigned

Mar 16, 2007

Last updated

Aug 23, 2019By the provider in NPPES

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: pat.tidwell.1@19478.direct.athenahealth.com

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1184758526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 203",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-897-3678",
            "fax_number": "850-373-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E HIGHWAY 20 STE 203",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325787700",
            "telephone_number": "850-897-3678",
            "fax_number": "850-373-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "PAT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME30890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Thomas, ARNP
• Melanie Jill Thompson, D.C.
• Victoria Thorson
• Helen Rhawn Tidwell, RN
• Jonathan D Tidwell, MD
• Rebecca Tippet, M.S. CCC-SLP
• Titan Hospitalist Group LLC
• Emily Towery, CRNP
• Tracey R Burton Lindner MD PA Dba (Pediatrics Of Okaloosa)
• Isabel Tran

• Family Medicine Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.