Paul Timothy Tidmore, NP - Medicare Nurse Practitioner in Knoxville, TN

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Paul Timothy Tidmore, NP is a medicare enrolled "Nurse Practitioner - Acute Care" in Knoxville, Tennessee. His current practice location is 2210 Sutherland Ave Ste 110, Knoxville, Tennessee. You can reach out to his office (for appointments etc.) via phone at (865) 525-4333.

Paul Timothy Tidmore is licensed to practice in Tennessee (license number 14982) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457671380.

Contact Information

Paul Timothy Tidmore, NP
2210 Sutherland Ave Ste 110,
Knoxville, TN 37919-2337
(865) 525-4333
(865) 374-2203

Map and Direction




Provider's Profile

Full NamePaul Timothy Tidmore
GenderMale
SpecialityNurse Practitioner - Acute Care
Location2210 Sutherland Ave Ste 110, Knoxville, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1457671380
  • Provider Enumeration Date: 06/02/2010
  • Last Update Date: 04/24/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9537342183
  • Enrollment ID: I20110321000329

Medical Identifiers

Medical identifiers for Paul Timothy Tidmore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457671380NPI-NPPES
1523332MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care 14982 (Tennessee)Primary

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. Paul Timothy Tidmore allows following entities to bill medicare on his behalf.
Entity NameEast Tennessee Surgical Group, P.c.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164589628
PECOS PAC ID: 2365497765
Enrollment ID: O20050318000318
Entity NameCovenant Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457302010
PECOS PAC ID: 2860305463
Enrollment ID: O20060719000030
Entity NameIntegrated Wound Care Tennessee Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215593991
PECOS PAC ID: 8527394477
Enrollment ID: O20190730002619

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. Paul Timothy Tidmore 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 AddressPractice Location Address
Paul Timothy Tidmore, NP
460 Medical Park Dr Ste 106,
Lenoir City, TN 37772-5782

Ph: (865) 988-4452		Paul Timothy Tidmore, NP
2210 Sutherland Ave Ste 110,
Knoxville, TN 37919-2337

Ph: (865) 525-4333

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.