Nastassia Tidwell

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

602 SW 38TH St
Lawton, OK 73505-6912

Phone

(580) 248-5436

NPI assigned

May 15, 2015

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 OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Our House Mhsa Inc

  • Mental Health Counselor
  • Lawton, OK
  • NPI 1790144160
  Medicare reassignment NPD

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1275911760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SW 38TH ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056912",
            "telephone_number": "580-248-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "NASTASSIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Sherrie Thorne
• Jerry Lee Thorne
• Hannah McRaney Thrasher, BSDH, RDH
• Brittni Thurman
• Ruth Ann Thurston
• Elizabeth Tilghman
• Kyla Lynn Tillis, COTA
• Timothy F Wright, MD
• Janet Laura Tippeconnic
• Devin Eli Toahty

• Case Manager/Care Coordinator in Lawton, OK
• Providers in Lawton, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.