Heidi Olsen Tidwell, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

269056-2401 Issued in UT

Practice address

1551 Renaissance Towne Dr Ste 420
Bountiful, UT 84010-7677

Phone

(801) 295-8999

NPI assigned

Apr 2, 2019

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

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportsmed Physical Therapy of Bountiful a Professional CorpGroup PAC ID 2668462045, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sportsmed Physical Therapy of Bountiful a Professional Corp

  • Physical Therapy Clinic/Center
  • Bountiful, UT
  • NPI 1215119870
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1669934378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 420",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107677",
            "telephone_number": "801-295-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 420",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107677",
            "telephone_number": "801-295-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "HEIDI",
        "middle_name": "OLSEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": "269056-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Thompson, DPT
• Eliza Ruth Thompson
• Paula Thompson
• Jeremy E Thueson, MD
• Brittney Kristine Tidwell
• Kaylie Nicole Tietjen
• Brenda Till
• Eryn A Tim
• TLC Hospice
• Todd C. Liston DDS, Ms, PC

• Orthopedic Physical Therapist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Orthopedic Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.