NPIMap

Organization Active NPI

Accident Spine & Rehab

  • Rehabilitation Chiropractor
  • Birmingham, AL
National Provider Identifier
1609207968
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
1932 Issued in AL
Legal business name
ACCIDENT SPINE & REHAB
Practice address
240 Gadsden Hwy
Birmingham, AL 35235-1006
Phone
(205) 561-6005
Fax
(205) 201-5004
NPI assigned
Dec 11, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Brent Alan Tidwell, D.C.NPI 1154438802
Title
President
Phone
(256) 383-5772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 1932 AL Primary

Addresses

Primary practice location

240 Gadsden Hwy
Birmingham, AL 35235-1006

Mailing address

819 Mimosa Park Rd
Tuscaloosa, AL 35405-4839
Phone (205) 752-7503

Other practice location 1

2410 2nd St
Muscle Shoals, AL 35661-1265
Phone (256) 383-5772

National Provider Directory

National Provider Directory
Tax ID family
Accident Spine Rehab4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

240 Gadsden Hwy
Birmingham, AL 35235
Phone (205) 561-6005

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609207968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 MIMOSA PARK RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354054839",
            "telephone_number": "205-752-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 GADSDEN HWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352351006",
            "telephone_number": "205-561-6005",
            "fax_number": "205-201-5004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2410 2nd St",
            "address_purpose": "LOCATION",
            "city": "Muscle Shoals",
            "state": "AL",
            "postal_code": "356611265",
            "country_code": "US",
            "telephone_number": "256-383-5772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACCIDENT SPINE & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-383-5772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AL",
            "license": "1932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.