Active NPI
Julia Tidd
- Peer Specialist
- Vincent, OH
National Provider Identifier
1407565393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 4945 State Route 339
Vincent, OH 45784-5106 - Phone
- (740) 993-0399
- NPI assigned
- Nov 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary | ||
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
4945 State Route 339
Vincent, OH 45784-5106
Mailing address
4945 State Route 339
Vincent, OH 45784-5106
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angels Harbor | Current | Accepting new patients |
Locations
4945 State Route 339
Vincent, OH 45784
Phone (740) 371-5091
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 and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Belpre, OH
- NPI 1457000507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1407565393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4945 STATE ROUTE 339",
"city": "VINCENT",
"state": "OH",
"postal_code": "457845106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4945 STATE ROUTE 339",
"city": "VINCENT",
"state": "OH",
"postal_code": "457845106",
"telephone_number": "740-993-0399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDD",
"first_name": "JULIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-18",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vincent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.