Christina Michelle Tidwell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7597 Issued in GA

Practice address

1 Meadows Pkwy
Vidalia, GA 30474-8759

Phone

(912) 535-5555

Fax

(912) 535-5891

NPI assigned

May 27, 2015

Last updated

Jul 25, 2024By the provider in NPPES

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

Other names 1

• Ms. Christina Michelle Dacey Former name

Medicare fee-for-service enrollment

Enrolled in GA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Authority of Candler CountyGroup PAC ID 5294623948, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Candler County Hospital Hospital, Metter, GA, CCN 111334

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christina.dacey@rts.gadirect.net
• Direct secure messaging: christina.tidwell.1@23328.direct.athenahealth.com
• Direct secure messaging: christina.tidwell@srpcc.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospital Authority of Candler County

  dba Candler County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Metter, GA
  • NPI 1588868947
  Medicare reassignment Care Compare group NPD
• Montgomery Emergency Group, LLC

  • Emergency Medicine Physician
  • Vidalia, GA
  • NPI 1861773764
  Medicare reassignment
• Hospital Authority of Candler County

  dba Pulaski Health & Wellness

  • Primary Care Clinic/Center
  • Pulaski, GA
  • NPI 1316523707
  NPD
• Hospital Authority of Candler County

  dba Candler Medical Group RHC

  • Rural Health Clinic/Center
  • Metter, GA
  • NPI 1790088169
  NPD (past)

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

• Hospital Authority of Candler County

  dba Candler County Hospital

  • Critical Access Hospital
  • Metter, GA
  • NPI 1790888089
  Care Compare affiliation

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1528447372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304390597",
            "telephone_number": "912-685-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEADOWS PKWY",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748759",
            "telephone_number": "912-535-5555",
            "fax_number": "912-535-5891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Harris Industrial Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748854",
            "country_code": "US",
            "telephone_number": "912-535-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Doctors St",
            "address_purpose": "LOCATION",
            "city": "Metter",
            "state": "GA",
            "postal_code": "30439",
            "country_code": "US",
            "telephone_number": "912-685-5715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "637 S. Lewis St.",
            "address_purpose": "LOCATION",
            "city": "Metter",
            "state": "GA",
            "postal_code": "30439",
            "country_code": "US",
            "telephone_number": "912-685-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 R T Stanley Sr Place",
            "address_purpose": "LOCATION",
            "city": "Lyons",
            "state": "GA",
            "postal_code": "30436",
            "country_code": "US",
            "telephone_number": "912-526-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "CHRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "DACEY",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Oaks - Bethany Skilled Nursing, LLC (The Oaks - Bethany Skilled Nursing)
• Thomas M. Allen M.D., LLC
• Pam McIntyre Or Lou Thompson, RD LD RDN LDN
• Taylor Thompson
• Three Rivers Home Health Services, Inc.
• Ashlee Nicole Sharer Tillery, MD
• Katrina A Toler, CERTIFIED FIRST ASSI
• Sarah Hammock Toler, FNP-C
• Toombs County Commissioners (Toombs County EMS)
• Toombs County Dental Clinic

• Physician Assistant in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.