Grace Tidwell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

160389 Issued in CA

Practice address

155 15TH St Ste a
West Sacramento, CA 95691-3737

Phone

(916) 454-2345

Fax

(916) 457-2667

NPI assigned

Apr 24, 2014

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 CA

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

Family Practice

Education

University of South Florida College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cares Community Health 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gtidwell751358@direct.ochin.org

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.

• Cares Community Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1447297379

  CA

  Medicare reassignment Care Compare group NPD
• Cares Community Health

  • Federally Qualified Health Center (FQHC)
  • Carmichael, CA
  • NPI 1255180873
  Care Compare group NPD
• Cares Community Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1982114492
  Care Compare group NPD
• Cares Community Health

  • Durable Medical Equipment & Medical Supplies
  • Sacramento, CA
  • NPI 1629096607
  Care Compare group

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1437579786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484",
            "fax_number": "916-256-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 15TH ST STE A",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913737",
            "telephone_number": "916-454-2345",
            "fax_number": "916-457-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "160389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Louise Thompson
• Michaela Taylor Thompson
• Thrifty Payless Inc
• Amber Choisella Thuston, MSC, LPCC
• Jim L Thweatt, PT
• Denise I. Tillery, LCSW
• Lisa Christine Timpone, ATC
• Nancy E Tinajero, ASW
• Darian Lynn Tolson
• Rothana Torn

• All providers in West Sacramento, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.