Individual provider Active NPI

Brittany Davis Tidd, PNP

  • Pediatric Nurse Practitioner
  • Newton, NC
National Provider Identifier
1669061883
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5013917 Issued in NC
Practice address
3975 Robinson Rd
Newton, NC 28658-9715
Phone
(828) 466-0466
Fax
(828) 466-8862
NPI assigned
Jan 12, 2021
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013917 NC
Pediatric Nurse Practitioner 363LP0200X 5013917 NC Primary

Addresses

Primary practice location

3975 Robinson Rd
Newton, NC 28658-9715

Mailing address

3975 Robinson Rd
Newton, NC 28658-9715
Phone (828) 466-0466

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address btidd@carolinacaring.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210120000383 NC Practitioner - Nurse Practitioner 9234542911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5013917NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Caring Serious Illness, LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

3975 Robinson Rd
Newton, NC 28658
Phone (828) 466-0466

Interoperability endpoints

  • Direct secure messaging: brittanytidd@pcchcv.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1669061883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 ROBINSON RD",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286589715",
            "telephone_number": "828-466-0466",
            "fax_number": "828-466-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 ROBINSON RD",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286589715",
            "telephone_number": "828-466-0466",
            "fax_number": "828-466-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDD",
        "first_name": "BRITTANY",
        "middle_name": "DAVIS",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013917",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5013917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "btidd@carolinacaring.org",
            "affiliation": "N",
            "address_1": "3975 Robinson Rd",
            "city": "Newton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286589715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newton, NC

Sources for this page

Verify at the official NPI Registry.