Katie Elizabeth Tidwell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12230861 Issued in TN

Practice address

765 Woodland Trace LN
Cordova, TN 38018-6609

Phone

(888) 551-2538

NPI assigned

Dec 29, 2023

Sex

Female

Sole proprietor

No

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

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Gateway Primary Care LLCGroup PAC ID 6204299274, 2 clinicians

Segue Health Partners LLCGroup PAC ID 5496020521, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Gateway Primary Care LLC

  • Primary Care Clinic/Center
  • Murfreesboro, TN
  • NPI 1912688250
  Medicare reassignment Care Compare group NPD
• Segue Health Partners LLC

  • Family Medicine Physician
  • Cordova, TN
  • NPI 1073040556
  Medicare reassignment Care Compare group NPD
• Gateway Healthcare, PC

  • Urgent Care Clinic/Center
  • Murfreesboro, TN
  • NPI 1770035214
  NPD (past)
• Physicians Quality Care PLLC

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1528240256
  NPD (past)

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1235908351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 WOODLAND TRACE LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186609",
            "telephone_number": "888-551-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 WOODLAND TRACE LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186609",
            "telephone_number": "888-551-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "KATIE",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-29",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F12230861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Thompson
• Verlee Renea Thompson, FNP-C
• Dawn Fay Thornton
• Thrive Healthcare & Wellness
• Tiarashaven & Support Services LLC
• Marquita Natalya Tidwell, COTA/L
• Tiffany R Smith
• Rylee Marie Tillman, NCC
• Timber Creek Medical
• Lisa P Timberlake, PHARMD

• Family Nurse Practitioner in Cordova, TN
• Providers in Cordova, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.