Lauren Blair Tidwell, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.1163 Issued in AL

Practice address

2317 Memorial Pkwy SW Ste 300
Huntsville, AL 35801-5623

Phone

(256) 881-4112

NPI assigned

Sep 23, 2016

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 AL

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

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurology Consultants of Huntsville PCGroup PAC ID 3678674082, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.33 of 100Reported as apm

Quality

82.81

Promoting interoperability

83.07

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Neurology Consultants of Huntsville, P.C.

  • Neurology Physician
  • Huntsville, AL
  • NPI 1871700799
  Medicare reassignment Care Compare group
• Panacea O'Neill Medical Group Inc

  • Family Medicine Physician
  • Madison, AL
  • NPI 1356870398
  Medicare reassignment
• Patrick J Oneill M.D., P.C.

  • Primary Care Clinic/Center
  • Madison, AL
  • NPI 1871863050
  NPD

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631318400000",
    "number": "1497204002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 MEMORIAL PKWY SW STE 300",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015623",
            "telephone_number": "256-881-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 MEMORIAL PKWY SW STE 300",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015623",
            "telephone_number": "256-881-4112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Spenryn Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "AL",
            "postal_code": "357581890",
            "country_code": "US",
            "telephone_number": "256-772-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Browns Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "AL",
            "postal_code": "357589601",
            "country_code": "US",
            "telephone_number": "256-461-7272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "LAUREN",
        "middle_name": "BLAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.1163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Tibbs, AGACNP
• Randall Tibbs, D.P.M.
• Ruvimbo Michelle Ticharwa
• Darriana Tichenor
• Faith Kristen Tidmore
• Rachel Sullivan Tieslau, MA, MS, RDN, LD, LPC
• David P Tietjen, MD
• Wilhelm Tietke, MD
• Sara Renee Tigner
• Tanya Ree Tilford

• Medical Physician Assistant in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.