Christen Tidwell, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

6188 Issued in TN

Practice address

3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481

Phone

(800) 774-7785

NPI assigned

Oct 24, 2016

Last updated

Oct 24, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1528510658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3784 N JOT DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405770",
            "telephone_number": "615-715-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 LAKE LYNDA DR STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328171481",
            "telephone_number": "800-774-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "CHRISTEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "6188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Ruth Tice
• Karsyn Skye Tichner, RBT
• Mhyryll Jerez Ticobay
• Cailyn Tidwell
• Chelsea Tidwell
• Tina Tidwell
• Amanda Tieken, PT, DPT
• Jung-Jung Tien, MD
• Christina Tiernan
• Willow Michele Tierney

• Physical Medicine & Rehabilitation Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.