Gregg Tidrick, DNP

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

227355 Issued in AZ

Practice address

2000 E Southern Ave Ste 102
Tempe, AZ 85282-7510

Phone

(480) 820-9141

NPI assigned

May 17, 2019

Sex

Male

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 AZ

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Arizona College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment Care Compare group NPD
• Pca Anesthesia

  • Anesthesiology Physician
  • Tempe, AZ
  • NPI 1164804258
  Medicare reassignment NPD
• Anesthesia Partners of Arizona LLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1619452901

  AZ

  Medicare reassignment NPD
• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
  • NPI 1124374822
  NPD
• Banner Hospital Based Physicians Arizona LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Phoenix, AZ
  • NPI 1780445171
  NPD

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

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1841856598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2688 E SANTA ROSA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341487",
            "telephone_number": "602-919-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E SOUTHERN AVE STE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827510",
            "telephone_number": "480-820-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDRICK",
        "first_name": "GREGG",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "227355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry Michael Thorstad, LPC
• Thriving Mind Solutions, PLLC
• Sandra Mari Thron, MA ED.
• Lilly Ann Mabel Thurlow
• Tiba Care PLLC
• Tiffany Trawick Counseling Services
• Joel Edwin Tiffany, DMD
• Tiger Care LLC
• Timothy E Black MD PC
• Jessica Tindal

• Certified Registered Nurse Anesthetist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Certified Registered Nurse Anesthetist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.