Brett R Tidwell, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OS13152 Issued in FL

Practice address

27 Mack Bayou Loop
Ste 2000
Santa Rosa Beach, FL 32459-2613

Phone

(850) 267-2961

Fax

(850) 622-5634

NPI assigned

Jun 15, 2012

Sex

Male

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brett.tidwell.2@9582.direct.athenahealth.com
• Direct secure messaging: brett.tidwell.1@9582.direct.athenahealth.com

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.

• Sacred Heart Health System, Inc.

  • Ambulatory Family Planning Facility
  • Pensacola, FL
  • NPI 1962453308
  Medicare reassignment Care Compare group NPD
• Sacred Heart Health System Inc

  • Community/Retail Pharmacy
  • Pensacola, FL
  • NPI 1366260739
  NPD
• Sacred Heart Health System, Inc.

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1144271586
  NPD
• Sacred Heart Health System, Inc.

  • Primary Care Clinic/Center
  • Pensacola, FL
  • NPI 1043261498
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1417210352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "ATTN: SHMG/HPE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-267-2961",
            "fax_number": "850-622-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MACK BAYOU LOOP",
            "address_2": "STE 2000",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324592613",
            "telephone_number": "850-267-2961",
            "fax_number": "850-622-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "BRETT",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-15",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS13152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teg Inc.
• The Galen Group
• The Hope Center- Counseling
• The Reach Institute of North West Florida
• Scott Patrick Thurston, DC
• Crystal C Tidwell, DO
• Natalie Yazdani Tidwell, M.D.
• Tjal Enterprises Inc.
• TMJ & Sleep Center LLC
• Cynthia C Townsend, ARNP, FNP-BC

• Obstetrics & Gynecology Physician in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.