Randy Tidwell, APN in Portland, TN - Medicare Nurse Practitioner

Randy Tidwell, APN is a medicare enrolled "Nurse Practitioner - Family" in Portland, Tennessee. His current practice location is 421 N Broadway, Portland, Tennessee. You can reach out to his office (for appointments etc.) via phone at (615) 323-1020.

Randy Tidwell is licensed to practice in Tennessee (license number 13982) 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 1164661674.

Contact Information

	Randy Tidwell, APN
	421 N Broadway, Portland, TN 37148-1750
	(615) 323-1020
	(615) 323-1021

Map and Direction

Provider's Profile

Full Name	Randy Tidwell
Gender	Male
Speciality	Nurse Practitioner - Family
Location	421 N Broadway, Portland, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164661674
Provider Enumeration Date: 02/08/2009
Last Update Date: 08/03/2012

Medicare PECOS Information:

PECOS PAC ID: 0244388551
Enrollment ID: I20090424000337

Medical Identifiers

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

Identifier	Type	State	Issuer
1164661674	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	13982 (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. Randy Tidwell allows following entities to bill medicare on his behalf.

Entity Name	Tidwell Family Ventures Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518106020 PECOS PAC ID: 2163570474 Enrollment ID: O20090424000314

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. Randy 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
Randy Tidwell, APN Po Box 507, 421 N Broadway, Portland, TN 37148-0507 Ph: (615) 323-1020	Randy Tidwell, APN 421 N Broadway, Portland, TN 37148-1750 Ph: (615) 323-1020

Reviews and Comments

Nurse Practitioner Nurses in Portland, TN

Dr. Shelby Harpel, DNP, APRN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 235 Highway 52 W, Portland, TN 37148 Phone: 615-802-1087 Fax: 615-802-1088
Tasha Ruffin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 215 Highland Circle Dr, Portland, TN 37148 Phone: 615-325-9263
Ms. Brandy Nicole Carson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 307 Reed St, Portland, TN 37148 Phone: 615-525-8792
Natalie Elizabeth Brown, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 235 Highway 52 W, Portland, TN 37148 Phone: 615-802-1087
Lisa Nazarenus, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 307 S Broadway, Portland, TN 37148 Phone: 615-325-6755 Fax: 615-325-6936
Madeline Mccleary Gillon, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 215 Highland Dr, Portland, TN 37148 Phone: 615-325-9263

Randy Tidwell, APN - Medicare Nurse Practitioner in Portland, TN