Kristin Tidwell, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R0111034 Issued in OK

Practice address

1008 W Taft Ave
Sapulpa, OK 74066-8720

Phone

(918) 347-8090

NPI assigned

Jul 31, 2021

Sex

Female

Sole proprietor

Yes

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Neuropathy Treatment Clinic of Oklahoma LLCGroup PAC ID 5799025268, 4 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.

• Neuropathy Treatment Clinic of Oklahoma LLC

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1386185353
  Medicare reassignment Care Compare group NPD
• Revelation Medical of Tulsa LLC

  • Pain Medicine (Anesthesiology) Physician
  • Tulsa, OK
  • NPI 1366194110
  Medicare reassignment NPD
• L and M Investments LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1104437219
  NPD
• Transformation Health PLLC

  • Family Medicine Physician
  • Glenpool, OK
  • NPI 1497263818
  NPD (past)

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

{
    "created_epoch": "1627689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627689600000",
    "number": "1396418679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10488 S 86TH EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 W TAFT AVE",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740668720",
            "telephone_number": "918-347-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "KRISTIN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-31",
        "last_updated": "2021-07-31",
        "certification_date": "2021-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0111034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Taylor
• Terri Taylor
• Camille Chere Teale, NMD
• Sandy Terry
• Three Oaks LLC
• Sara Tillotson
• Donald Robert Titsworth II
• Lindsay Melea Tonelli
• Barbara Torbett, MA, CCC-SLP
• Julie Diane Torgeson, RN

• Family Nurse Practitioner in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2021; 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.