William James Tidwell, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

56778 Issued in TN

Practice address

100 Springhouse CT
Hendersonville, TN 37075-1609

Phone

(615) 824-7491

Fax

(615) 449-5740

NPI assigned

May 24, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Tennessee, HSC, College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cumberland Skin Surgery and DermatologyGroup PAC ID 0941391338, 55 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.25 of 100Reported as group

Promoting interoperability

85

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.tidwell@qdp.emadirect.md

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.

• Cumberland Skin Surgery and Dermatology

  • Medical Specialty Clinic/Center
  • Lebanon, TN
  • NPI 1922138247
  Medicare reassignment Care Compare group NPD
• Skin Solutions Dermatology & Skin Cancer Surgery, P.C.

  • Specialist
  • Franklin, TN
  • NPI 1215940366
  Medicare reassignment NPD
• Advanced Sleep Consultants of Middle TN, Inc

  • Medical Specialty Clinic/Center
  • Lebanon, TN
  • NPI 1912048307
  NPD (past)
• Stratum Health Collective PLLC

  • Integrative Medicine Physician
  • Brentwood, TN
  • NPI 1740121516
  NPD (past)

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1962849463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GLIDEPATH WAY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370904133",
            "telephone_number": "615-449-5771",
            "fax_number": "615-449-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRINGHOUSE CT",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370751609",
            "telephone_number": "615-824-7491",
            "fax_number": "615-449-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A147575",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "51181",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "51181",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A14575",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "56778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmin Thorpe, RN
• Amanda Katherine Thorsby
• Kammie Lynn Throckmorton, FNP
• Albert Christian Thurman
• Aylah Thysell
• TN Doctors of Optometry, PLLC
• TN Specialty Dental Services, PLLC
• Angela Toavs
• Kyndal Tobitt
• Aimee Todd, PA-C

• MOHS-Micrographic Surgery Physician in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• MOHS-Micrographic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.