Jessi Blackstock Tidwell, CRNP in Florence, AL

Jessi Blackstock Tidwell, CRNP is a medicare enrolled "Nurse Practitioner" in Florence, Alabama. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Evolve Behavioral Health Llc and her current practice location is 2904 Mall Rd, Florence, Alabama. You can reach out to her office (for appointments etc.) via phone at (256) 768-5350.

Jessi Blackstock Tidwell is licensed to practice in Alabama (license number 1-162142) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013556356.

Contact Information

	Jessi Blackstock Tidwell, CRNP
	2904 Mall Rd, Florence, AL 35630-1641
	(256) 768-5350
	(949) 695-4340

Map and Direction

Provider's Profile

Full Name	Jessi Blackstock Tidwell
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	2904 Mall Rd, Florence, Alabama
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jessi Blackstock Tidwell graduated from nursing school in 2020

NPI Data:

NPI Number: 1013556356
Provider Enumeration Date: 01/03/2020
Last Update Date: 05/01/2025

Medicare PECOS Information:

PECOS PAC ID: 3476938606
Enrollment ID: I20220923001027

Medical Identifiers

Medical identifiers for Jessi Blackstock Tidwell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013556356	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1-162142 (Alabama)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1-162142 (Alabama)	Secondary
363L00000X	Nurse Practitioner	1-162142 (Alabama)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Evolve Behavioral Health Llc	9032559521	4

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessi Blackstock Tidwell allows following entities to bill medicare on her behalf.

Entity Name	Shoals Health Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073851630 PECOS PAC ID: 6800033192 Enrollment ID: O20130503000428

Entity Name	Evolve Behavioral Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316708993 PECOS PAC ID: 9032559521 Enrollment ID: O20240501001270

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessi Blackstock Tidwell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jessi Blackstock Tidwell, CRNP 2904 Mall Rd, Florence, AL 35630-1641 Ph: (256) 394-0880	Jessi Blackstock Tidwell, CRNP 2904 Mall Rd, Florence, AL 35630-1641 Ph: (256) 768-5350

Reviews and Comments

Nurse Practitioner Nurses in Florence, AL

Kendra L Brown, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2612 Hough Rd, Florence, AL 35630 Phone: 256-275-3724 Fax: 877-441-0602
Ruthann Allison, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1609 Mockingbird Ct Ste B, Florence, AL 35630 Phone: 256-320-7781
Cameron Patrick Henderson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1701 Veterans Dr, Florence, AL 35630 Phone: 256-629-1000
Mrs. April Michelle Brooks, WHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 541 W. College St, 2400, Florence, AL 35630 Phone: 256-767-0081 Fax: 256-767-3077
Brittany Churchwell Gifford, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 541 W College St Ste 2400, Florence, AL 35630 Phone: 256-980-6999
Abbey Robinson, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2129 Helton Dr, Florence, AL 35630 Phone: 256-367-4916 Fax: 256-760-3145

Jessi Blackstock Tidwell, CRNP - Medicare Nurse Practitioner in Florence, AL