PAUL TIMOTHY TIDMORE NP NPI 1457671380

NPI Information

  • NPI: 1457671380
  • Provider Name: PAUL TIMOTHY TIDMORE, NP
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2210 SUTHERLAND AVE STE 110
    KNOXVILLE, TN
    ZIP 37919
  • Phone: (865) 525-4333

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NPI Details

Paul Timothy Tidmore, NP is an acute care nurse practitioner in Knoxville, TN with 16 years of experience. Paul Timothy Tidmore, NP NPI is 1457671380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:2009

The provider's business location address is:

2210 SUTHERLAND AVE STE 110
KNOXVILLE, TN
ZIP 37919-337
Phone: (865) 525-4333
Fax: (865) 374-2203

The NPI 1457671380 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 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.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)

The enumeration date for this NPI number is 6/2/2010 and was last updated on 4/24/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute Care14982TENNESSEEYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11523332MEDICAIDTENNESSEE

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: 3/30/2025

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