KATIE ELIZABETH TIDWELL (FNP) – Family Nurse Practitioner, NPI 1235908351

KATIE ELIZABETH TIDWELL (FNP) is a healthcare provider. based in Cordova, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. F12230861 (TN). The NPI Number for KATIE ELIZABETH TIDWELL (FNP) is 1235908351

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KATIE ELIZABETH TIDWELL (FNP)
NPI
1235908351
Phone
(888) 551-2538
Address
765 WOODLAND TRACE LN
Enumeration Date
29 December 2023
Last Update Date
16 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9016263515
Graduation Year
2023 (3 years ago)
PAC ID
5092157172
Group Practice PAC ID
5496020521
Professional Enrollment ID
I20240521001468
Address ID
TN380186609CO765XXLNXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

10,664 NURSE PRACTITIONER in TN

Provider Addresses for KATIE ELIZABETH TIDWELL (FNP)

  • 765 WOODLAND TRACE LN

    CORDOVA, TN 380186609

    Phone: (888) 551-2538

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $98.

Total Amount is formed as General ($98) + Research ($0) + Ownership ($0) = $98.

Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Amgen Inc. ($31).

Total Amount

$98

General + Research + Ownership

Payments

6

Total payment records

General Amount

$98

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-12

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240521001468INurse PractitionerTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38018)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496020521View full group profile
NameSpecialtyState
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerMS
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

Is there an official ID for KATIE ELIZABETH TIDWELL (FNP) in U.S. healthcare records?
The official identifier for KATIE ELIZABETH TIDWELL (FNP) is NPI 1235908351.
Would KATIE ELIZABETH TIDWELL (FNP) appear as active to a payer?
You can treat KATIE ELIZABETH TIDWELL (FNP) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for KATIE ELIZABETH TIDWELL (FNP)?
At a glance, KATIE ELIZABETH TIDWELL (FNP) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Tennessee is KATIE ELIZABETH TIDWELL (FNP) registered?
Use Cordova, Tennessee as the headline location for KATIE ELIZABETH TIDWELL (FNP) here.
When was this NPI issued?
Enumeration for KATIE ELIZABETH TIDWELL (FNP) is noted as December 29, 2023 where the registry provides it.

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