NPIMap

Individual provider Active NPI

William Tidwell, M.D.

  • Diagnostic Radiology Physician
  • Meridian, MS
National Provider Identifier
1801072632
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
19358 Issued in MS
Practice address
1800 12TH St
Meridian, MS 39301-4158
Phone
(601) 703-9544
Fax
(601) 703-9295
NPI assigned
Jan 10, 2008
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 19358 MS Primary

Addresses

Primary practice location

1800 12TH St
Meridian, MS 39301-4158

Mailing address

1800 12TH St
Meridian, MS 39301-4158
Phone (601) 703-9544

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wtidwell@mrhc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080805000352 MS Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8224102520 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Mississippi School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tippah County HospitalGroup PAC ID 5193746709, shared by 6 NPIs, 24 clinicians
Magnolia Imaging Associates, PLLCGroup PAC ID 2264660026, 4 clinicians
Magnolia Regional Health CenterGroup PAC ID 9739078460, 15 clinicians

Practice addresses (Care Compare)

1005 -A City Ave N
Ripley, MS 38663-1414
Phone (662) 837-9221

611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 286-0090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19358MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tippah County Hospital CurrentSince Jul 1, 2008 Accepting new patients
Tippah County Hospital CurrentSince Oct 1, 2023 Accepting new patients
Tippah County Hospital Current Accepting new patients
Tippah County Hospital CurrentSince Jul 1, 2008 Accepting new patients

Locations

1005 City Ave N
Ripley, MS 38663
Phone (601) 837-9221

1005 City Ave N
#A
Ripley, MS 38663
Phone (662) 837-2202

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/tippah-ba3c06de

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1801072632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-9544",
            "fax_number": "601-703-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-9544",
            "fax_number": "601-703-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "19358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wtidwell@mrhc.org",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "611 Alcorn Dr",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388349321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.