KATIE ELIZABETH TIDWELL FNP
NPI 1235908351
Nurse Practitioner - Family in Cordova, TN

Q: What is Katie Tidwell's NPI number?

The NPI number for Katie Tidwell is 1235908351. It was assigned to this individual provider in the NPPES registry on December 29, 2023.

Q: What is Katie Tidwell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Katie Tidwell was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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 December 29, 2023PECOS EnrolledAccepts Medicare Assignment

765 WOODLAND TRACE LN, CORDOVA, TN 38018(888) 551-2538 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 16, 2025, Apr 8, 2024, Jan 2, 2024 (3 updates tracked since 2024).

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About Katie Elizabeth Tidwell Fnp NPPES

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

KATIE ELIZABETH TIDWELL FNP (NPI 1235908351) is an individual family provider in Cordova, Tennessee, licensed in Tennessee (F12230861) and active in the NPI registry since December 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1235908351

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKATIE ELIZABETH TIDWELLCredential: FNP

Location Address765 WOODLAND TRACE LNCordova, TN 38018-6609

Mailing Address765 Woodland Trace LnCordova, TN 38018-6609 · (888) 551-2538

Phone(888) 551-2538

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateDecember 29, 2023

Last NPPES UpdateDecember 16, 20253 updates tracked since enumeration

NPPES CertifiedDecember 16, 2025

✔ NPI 1235908351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TN · F12230861

765 WOODLAND TRACE LN, Cordova, TN 38018

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama 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 and accepts Medicare assignment

Katie Elizabeth Tidwell Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092157172

PECOS Enrollment IDI20240521001468

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

Segue Health Partners LLC

Same address

Family Medicine

765 WOODLAND TRACE LN
Cordova, TN 38018

Reassigned Medicare billing, Tennessee enrollment
47 clinicians in this Medicare group

NPI 1073040556 (901) 493-0111

Gateway Primary Care LLC

189 mi

Primary Care

5607 FRANKLIN RD STE A1
Murfreesboro, TN 37128

Reassigned Medicare billing, Tennessee enrollment

NPI 1912688250 (615) 894-0990

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

26 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38018 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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 9

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

MR. COREY KONEMANN FNP-C

Nurse Practitioner (Family)