NASTASSIA TIDWELL
NPI 1275911760
Case Manager/Care Coordinator in Lawton, OK

Q: What is Nastassia Tidwell's NPI number?

The NPI number for Nastassia Tidwell is 1275911760. It was assigned to this individual provider in the NPPES registry on May 15, 2015.

Q: What is Nastassia Tidwell's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

Q: When was this NPI record last updated?

The NPPES record for Nastassia Tidwell was last updated on May 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 May 15, 2015PECOS Enrolled

602 SW 38TH ST, LAWTON, OK 73505(580) 248-5436 Get Directions Write a Review

NPPES record last updated: May 15, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Nastassia Tidwell NPPES

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

NASTASSIA TIDWELL (NPI 1275911760) is an individual case manager/care coordinator provider in Lawton, Oklahoma and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275911760

Entity TypeIndividualFemale

Primary Taxonomy171M00000X

Provider Legal NameNASTASSIA TIDWELL

Location Address602 SW 38TH STLawton, OK 73505-6912

Mailing Address602 Sw 38th StLawton, OK 73505-6912

Phone(580) 248-5436

Sole ProprietorNo

Enumeration DateMay 15, 2015

✔ NPI 1275911760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers

Taxonomy Code171M00000X

Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

602 SW 38TH ST, Lawton, OK 73505

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nastassia Tidwell 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 Reassignment

Medicare enrollment records show Nastassia Tidwell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Our House Mhsa Inc

3.0 mi

Mental Health

2305 SW H AVE
Lawton, OK 73505

Reassigned Medicare billing, Oklahoma enrollment
15 clinicians in this Medicare group

NPI 1790144160 (580) 699-8000

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

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.

IESHA CARTER

Counselor (Mental Health)