Active NPI
Chad Tidwell, DO
- Pulmonary Disease Physician
- Greeley, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- DR.0077264
- Practice address
- 6767 29TH St FL 2
Greeley, CO 80634-5474 - Phone
- (970) 224-9102
- Fax
- (970) 224-9112
- NPI assigned
- Apr 27, 2020
- Last updated
- Jul 22, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Pulmonary Disease Physician | 207RP1001X | DR.0077264 | CO | Primary |
Addresses
Primary practice location
6767 29TH St FL 2
Greeley, CO 80634-5474
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Group | Current | Accepting new patients |
Locations
3990 John R St
Detroit, MI 48201
Phone (313) 745-6211
400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006
4100 John R St
Detroit, MI 48201
Phone (313) 576-8530
4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615
4201 Saint Antoine St
#9C
Detroit, MI 48201
Phone (313) 966-0463
1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200
Interoperability endpoints
- chad.tidwell.1@13014.direct.athenahealth.com
- chad.tidwell.1@19711.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1396366720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389071",
"telephone_number": "970-624-4439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6767 29TH ST FL 2",
"city": "GREELEY",
"state": "CO",
"postal_code": "806345474",
"telephone_number": "970-224-9102",
"fax_number": "970-224-9112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "CHAD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-27",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CO",
"license": "DR.0077264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.