Active NPI
Teri Tidwell
- Physical Therapist
- Midland, MI
National Provider Identifier
1790276996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501006181
- Practice address
- 4401 Campus Ridge Dr
Midland, MI 48640-6112 - Phone
- (989) 837-9100
- Fax
- (989) 837-9105
- NPI assigned
- May 23, 2018
- Last updated
- Jan 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501006181 | MI | Primary |
Addresses
Primary practice location
4401 Campus Ridge Dr
Midland, MI 48640-6112
Mailing address
4742 Briarwood CT
Auburn, MI 48611-8514
Phone (810) 278-4599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mymichigan Medical Center Midland | Past | Accepting new patients |
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.
-
- Anesthesiology Physician
- Midland, MI
- NPI 1649010455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1790276996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4742 BRIARWOOD CT",
"city": "AUBURN",
"state": "MI",
"postal_code": "486118514",
"telephone_number": "810-278-4599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 CAMPUS RIDGE DR",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406112",
"telephone_number": "989-837-9100",
"fax_number": "989-837-9105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDWELL",
"first_name": "TERI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-23",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501006181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.