John Edward Tidwell, MD

Primary specialty

Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X

License

58407 Issued in AZ

Practice address

702 E Bell Rd Ste 117
Phoenix, AZ 85022-6648

Phone

(480) 874-2040

Fax

(480) 874-2041

NPI assigned

Jun 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Orthopedic Surgery

Education

Medical College of Georgia School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sonoran Orthopaedic Trauma SurgeonsGroup PAC ID 5991735979, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Honor Health John C. Lincoln Medical Center Hospital, Phoenix, AZ, CCN 030014

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5564/brand/1/csg/1/fhir/r4

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.

• Sonoran Orthopaedic Trauma Surgeons

  • Orthopaedic Trauma Physician
  • Scottsdale, AZ
  • NPI 1952357022
  Medicare reassignment Care Compare group NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment NPD
• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• Kern County Hospital Authority

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1376623538
  Medicare reassignment NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1316228802
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1629301734
  NPD
• Kern County Hospital Authority

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1376960005
  NPD
• University Faculty Associates, Inc.

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1235537283
  NPD (past)

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

• Honorhealth

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1770690695
  Care Compare affiliation

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1184885519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 N CIVIC CENTER PLZ",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516912",
            "telephone_number": "480-874-2040",
            "fax_number": "480-874-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 E BELL RD STE 117",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850226648",
            "telephone_number": "480-874-2040",
            "fax_number": "480-874-2041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10240 W Indian School Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850375905",
            "country_code": "US",
            "telephone_number": "480-874-2040",
            "fax_number": "480-874-2041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3126 N Civic Center Plz",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516912",
            "country_code": "US",
            "telephone_number": "480-874-2040",
            "fax_number": "480-874-2041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "58407",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "AZ",
            "license": "58407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noel Bascon Tibajia, D.D.S.
• Heather Tibbett
• Brittany Tibbetts
• Meagan Elizabeth Tibbo, M.D.
• Heather Angelica Tidwell, PHARM.D.
• Judy L Tiede, RNFA
• Mark A Tiede, CRNA
• Anthony Tiedemann
• Lindsey Tieman
• Thuy Ngan Tieu, FNP

• Orthopaedic Trauma Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Orthopaedic Trauma Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.