MRS. JENNIFER F TIDWELL CRNP
NPI 1205335999
Nurse Practitioner in Montgomery, AL

Q: What is Jennifer Tidwell's NPI number?

The NPI number for Jennifer Tidwell is 1205335999. It was assigned to this individual provider in the NPPES registry on February 7, 2018.

Q: What is Jennifer Tidwell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Tidwell was last updated on January 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 07, 2018PECOS Enrolled

488 SAINT LUKES DR, MONTGOMERY, AL 36117(334) 288-7808(334) 288-8089 Get Directions Write a Review

NPPES record last updated: January 4, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 4, 2021, Dec 17, 2019, Oct 25, 2019 (3 updates tracked since 2019).

On this page

About Mrs. Jennifer F Tidwell Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JENNIFER F TIDWELL CRNP (NPI 1205335999) is an individual nurse practitioner in Montgomery, Alabama, licensed in Alabama (1-129613) and active in the NPI registry since February 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205335999

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMRS. JENNIFER F TIDWELLCredential: CRNP

Location Address488 SAINT LUKES DRMontgomery, AL 36117-7104

Mailing Address448 Saint Lukes DrMontgomery, AL 36117-7104 · (334) 288-7808 · Fax (334) 288-8089

Phone(334) 288-7808

Fax(334) 288-8089

Sole ProprietorNo

Enumeration DateFebruary 7, 2018

Last NPPES UpdateJanuary 4, 20213 updates tracked since enumeration

NPPES CertifiedJanuary 4, 2021

✔ NPI 1205335999 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in AL · 1-129613

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 1-129613 (AL)

488 SAINT LUKES DR, Montgomery, AL 36117

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Jennifer F Tidwell Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Jennifer Tidwell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Emergency Services Of Montgomery PC

17 mi

Emergency Medicine

124 S MEMORIAL DR
Prattville, AL 36067

Reassigned Medicare billing, Alabama enrollment
223 clinicians in this Medicare group

NPI 1528310323 (334) 365-0651

Children's Urgent Care, LLC

79 mi

Urgent Care

500 CAHABA PARK CIR, STE 100
Birmingham, AL 35242

Reassigned Medicare billing, Alabama enrollment
Medicare enrollment name: Childrens Urgent Care, LLC
98 clinicians in this Medicare group

NPI 1124541438 (205) 848-2273

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KATELYN PERRY BARNES NP-C, FNP

Nurse Practitioner