Justin Tidwell, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

L5926 Issued in TX

Practice address

604 Indiana
Lubbock, TX 79415

Phone

(806) 775-9700

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Kansas School of Med (KC/Wich/Sal), 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lubbock County Hospital DistrictGroup PAC ID 4284617507, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center Hospital, Lubbock, TX, CCN 450686

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Lubbock County Hospital District

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1508855578
  Medicare reassignment Care Compare group NPD
• Lubbock County Hospital District

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1063468031
  NPD (past)
• Lubbock County Hospital District

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1437170313
  NPD (past)

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

• Lubbock County Hospital District

  • Land Ambulance
  • Lubbock, TX
  • NPI 1174620546

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
  • NPI 1538245717

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • Community/Retail Pharmacy
  • Lubbock, TX
  • NPI 1679521652

  Hospital

  Care Compare affiliation
• Lubbock County Hospital District

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1821087164
  Care Compare affiliation
• Lubbock County Hospital District

  • Hearing and Speech Clinic/Center
  • Lubbock, TX
  • NPI 1831299114

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639199862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 53RD ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794133824",
            "telephone_number": "806-795-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 INDIANA",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79415",
            "telephone_number": "806-775-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L5926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gay Ann Tibbets, NURSE PRACTITIONER
• Lauren Marie Tibbit, CCC-SLP
• Aron Tidrick, DO
• Crockett Tidwell, RPH
• Jackson Coleman Tidwell
• Kirk Jon Tiemann, M.D.
• Matthew Tiemann, M.D.
• Zachary Jon Tiemann, MD
• Lukman Aderoju Tijani, MD
• Catherine Tillinghast, LPC

• Emergency Medicine Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.