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DR. SERENA DAVIS TIDWELL M.D. NPI 1033141031


NPI Information

NPI: 1033141031
Provider Name: DR. SERENA DAVIS TIDWELL, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 11D1010631

Address:
1538 13TH AVE
SUITE C 200
COLUMBUS, GA
ZIP 31901
Phone: (706) 320-2547
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DR. Serena Davis Tidwell, M.D. is a specialist in Columbus, GA with 26 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Serena Davis Tidwell, M.D. NPI is 1033141031. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year:1998

The provider's business location address is:

1538 13TH AVE
SUITE C 200
COLUMBUS, GA
ZIP 31901-956
Phone: (706) 320-2547
Fax: (706) 320-2549

The NPI 1033141031 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 11D1010631 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Bone density measurement using dedicated x-ray machine (HCPCS:77080)
  • Ultrasound pelvis through vagina (HCPCS:76830)

The enumeration date for this NPI number is 7/7/2006 and was last updated on 3/17/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist051192GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H58549MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.