Katherine Elizabeth Tidwell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

350034 Issued in NY

Practice address

15 S Main St Ste 150
Jamestown, NY 14701-6627

Phone

(727) 519-3447

NPI assigned

Aug 3, 2022

Sex

Female

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Physician Practice PCGroup PAC ID 6709007701, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Chautauqua at Wca Hospital, Jamestown, NY, CCN 330239
• Brooks-TLC Hospital System, Inc Hospital, Dunkirk, NY, CCN 330229

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.tidwell@upmcdirect.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.

• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176
  Medicare reassignment Care Compare group NPD
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD

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

• Brooks - TLC Hospital System Inc

  • Family Medicine Physician
  • Gowanda, NY
  • NPI 1538419502

  Hospital

  Care Compare affiliation
• Brooks - TLC Hospital System, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Derby, NY
  • NPI 1225654494

  Hospital

  Care Compare affiliation
• Brooks - TLC Hospital System, Inc.

  • Urgent Care Clinic/Center
  • Gowanda, NY
  • NPI 1487738886

  Hospital

  Care Compare affiliation
• Brooks-TLC Hospital System, Inc.

  • General Acute Care Hospital
  • Dunkirk, NY
  • NPI 1215917224
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Jamestown, NY
  • NPI 1568023687
  Care Compare affiliation
• Upmc Chautauqua at Wca

  • General Acute Care Hospital
  • Jamestown, NY
  • NPI 1770573222
  Care Compare affiliation

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1972230563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST STE 150",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016627",
            "telephone_number": "727-519-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST STE 150",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016627",
            "telephone_number": "727-519-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDWELL",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne M Thomas, LMSW
• Dennis Thomas Jr., BSN RN
• Lynn Thomas
• Ashley Thompson
• Tenille M Thompson, M.S. CCC-SLP
• Timothy J. Grace O.D.,P.C.
• Miriam L Todd, OTR/L
• Sandra Jean Tomaka, RN
• Peter A Tomasello Jr., DO
• Billy Toms, MD

• Family Nurse Practitioner in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.