Active NPI
Pamela Tidwell, COTA
- Occupational Therapy Assistant
- Murfreesboro, TN
National Provider Identifier
1225435993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1158
- Practice address
- 205 Ed Todd CT
Murfreesboro, TN 37128-7742 - Phone
- (615) 566-7543
- NPI assigned
- Nov 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1158 | TN | Primary |
Addresses
Primary practice location
205 Ed Todd CT
Murfreesboro, TN 37128-7742
Mailing address
205 Ed Todd CT
Murfreesboro, TN 37128-7742
Phone (615) 566-7543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1158 | TN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416787200000",
"number": "1225435993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 ED TODD CT",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371287742",
"telephone_number": "615-566-7543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 ED TODD CT",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371287742",
"telephone_number": "615-566-7543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "PAMELA",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-24",
"last_updated": "2014-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TN",
"license": "1158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.