Individual provider Active NPI

Cameron Austin Tidwell, NP-C

  • Nurse Practitioner
  • Macon, GA
National Provider Identifier
1689228918
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN258890 Issued in GA
Practice address
3708 Northside Dr
Macon, GA 31210-2404
Phone
(478) 745-4206
Fax
(478) 254-5463
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN258890 GA Primary

Addresses

Primary practice location

3708 Northside Dr
Macon, GA 31210-2404

Mailing address

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191023003577 GA Practitioner - Nurse Practitioner 3072845064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macon Orthopaedic and Hand Center, PAGroup PAC ID 7911994835, 87 clinicians

Practice addresses (Care Compare)

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

Hospital & facility affiliations

  • Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
  • Bleckley Memorial Hospital Hospital, Cochran, GA, CCN 111302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN258890GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Macon Orthopaedic & Hand Center, PA Nurse Practitioner CurrentSince Mar 23, 2020 Accepting new patients
Macon Orthopaedic & Hand Center, PA Nurse Practitioner CurrentSince Mar 23, 2020 Accepting new patients

Locations

2510 GA Highway 127
Kathleen, GA 31047
Phone (478) 352-7143

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

3708 Northside Dr
Macon, GA 31210
Phone (478) 254-5303

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

301 Margie Dr
Warner Robins, GA 31088
Phone (478) 953-5800

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Interoperability endpoints

  • Direct secure messaging: cameron.tidwell.1@4291.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1689228918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "CAMERON",
        "middle_name": "AUSTIN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN258890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.