NPIMap

Organization Active NPI

Accident Spine and Rehab Inc

  • Rehabilitation Chiropractor
  • Tuscaloosa, AL
National Provider Identifier
1861759110
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2100 Issued in AL
Legal business name
ACCIDENT SPINE AND REHAB INC
Practice address
345 Bear Creek Cutoff Rd Ofc Road
Tuscaloosa, AL 35405-5964
Phone
(205) 561-6000
Fax
(205) 759-2709
NPI assigned
Apr 11, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Brent A Tidwell, D.C.
Title
President
Phone
(205) 561-2195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 2100 AL Primary

Addresses

Primary practice location

345 Bear Creek Cutoff Rd Ofc Road
Tuscaloosa, AL 35405-5964

Mailing address

819 Mimosa Park Rd
Suite D
Tuscaloosa, AL 35405-4839
Phone (205) 561-2195

Other practice location 1

5945 Knight Ave
Suite C
Tuscaloosa, AL 35405-5503
Phone (205) 561-2195

National Provider Directory

National Provider Directory
Tax ID family
Accident Spine Rehab4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

345 Bear Creek Cutoff Rd
Ofc Rd
Tuscaloosa, AL 35405
Phone (205) 561-6000

5945 Knight Ave
Ste C
Tuscaloosa, AL 35405
Phone (205) 561-2195

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861759110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 MIMOSA PARK RD",
            "address_2": "SUITE D",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354054839",
            "telephone_number": "205-561-2195",
            "fax_number": "205-752-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BEAR CREEK CUTOFF RD OFC ROAD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354055964",
            "telephone_number": "205-561-6000",
            "fax_number": "205-759-2709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5945 Knight Ave",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354055503",
            "country_code": "US",
            "telephone_number": "205-561-2195",
            "fax_number": "205-752-7513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACCIDENT SPINE AND REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-561-2195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AL",
            "license": "2100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.