Sara Tidrow, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704223701 Issued in MI

Practice address

15125 22 Mile Rd
Shelby Township, MI 48315-4406

Phone

(586) 532-0599

NPI assigned

May 5, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stidrow1155708@direct.hfhs.org
• Direct secure messaging: sara.tidrow.1@7131.direct.athenahealth.com

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.

• Shelby Pediatric Associates and Child Lung Center PC

  • Pediatrics Physician
  • Shelby Township, MI
  • NPI 1124051990
  NPD (past)

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1851037618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 WOODMIRE DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161745",
            "telephone_number": "586-216-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154406",
            "telephone_number": "586-532-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDROW",
        "first_name": "SARA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704223701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Octavia Nekala Thompson
• Natalie Thorson
• Thrive Behavioral Health (Thrive Behavioral Health of Michigan)
• Thrive Behavioral Health of Michigan
• Thriverx PLLC
• Tiffany Danyal Shelby PLLC (Shelby Family Dentistry)
• Crystal Tillman
• Clarita Tobias
• Gisele Toma
• Rachel Tomaszewski, PT, DPT

• Family Nurse Practitioner in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.

Verify at the official NPI Registry.