Nicole Lynn Tidd

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

18998 Issued in SC

Practice address

1137 Cook Rd
Orangeburg, SC 29118-8204

Phone

(803) 531-0970

Fax

(803) 395-2237

NPI assigned

Aug 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score

80.41 of 100Reported as group

Quality

64.93

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ntidd442458@direct.musc.edu

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.

• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment Care Compare group NPD
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Musc Community Physicians

  • Family Medicine Physician
  • Bamberg, SC
  • NPI 1992383145
  NPD
• Regional Medical Center of Orangeburg and Calhoun Counties

  • Community/Retail Pharmacy
  • Orangeburg, SC
  • NPI 1467709881
  NPD (past)

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

• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1073605879
  Care Compare affiliation
• Medical University Hospital Authority

  • Rehabilitation Hospital
  • Orangeburg, SC
  • NPI 1154020147
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1659435840
  Care Compare affiliation
• Medical University Hospital Authority

  • Psychiatric Hospital
  • Orangeburg, SC
  • NPI 1669171740
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1710683354
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1770280299
  Care Compare affiliation

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1700295284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-2200",
            "fax_number": "803-395-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 COOK RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291188204",
            "telephone_number": "803-531-0970",
            "fax_number": "803-395-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDD",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "18998",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "18998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP NUMBER",
            "identifier": "GP6199",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sidney F. Thomas, OD
• Carmen Thompson, RD,
• Charles Page Thompson Jr., RPH
• Erica Thompson, FNP-BC
• Morris Lewis Thompson
• Lewis Traywick Till Jr.
• Tamara Till, FNP-BC
• Kennedy Toole, PA-C
• Top Care Concierge, LLC
• Total Dental Care of Orangeburg

• Adult Health Nurse Practitioner in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2017; 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.