Antonia Tidwell, RDMS, RVT, RDCS, RTR

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

115198 Issued in TN

Practice address

323 Savannah RDG
Murfreesboro, TN 37127-8331

Phone

(615) 708-3179

NPI assigned

Sep 3, 2012

Last updated

Sep 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

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": "1346630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346630400000",
    "number": "1548519739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 SAVANNAH RDG",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371278331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 SAVANNAH RDG",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371278331",
            "telephone_number": "615-708-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "ANTONIA",
        "credential": "RDMS, RVT, RDCS, RTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-03",
        "last_updated": "2012-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246XS1301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": "TN",
            "license": "115198",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "TN",
            "license": "310458",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "TN",
            "license": "115198",
            "primary": true
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "TN",
            "license": "115198",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Alan Thurman, PT, DPT
• Jacqueline Hope Thurstenson, MS, RDN, LDN
• Ryan P Thurston, DPM
• Todd Allen Tice, PH.D.
• Pamela Tichenor
• Pamela Tidwell, COTA
• Timothy Tidwell, DPH
• Michael Shay Tilley, DMD
• Charles Tillman
• Karen Jane Timmerman, PT

• Sonography Radiologic Technologist in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Sonography Radiologic Technologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2012; 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.