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PAUL TIMOTHY TIDMORE NP
NPI 1457671380
Nurse Practitioner - Acute Care in Knoxville, TN

Active since June 02, 2010PECOS Enrolled
2210 SUTHERLAND AVE STE 110, KNOXVILLE, TN 37919(865) 525-4333(865) 374-2203 Get Directions Write a Review

NPPES record last updated: April 24, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 24, 2024, May 24, 2022 (2 updates tracked since 2022).

About Paul Timothy Tidmore Np NPPES

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

PAUL TIMOTHY TIDMORE NP (NPI 1457671380) is an individual acute care provider in Knoxville, Tennessee, licensed in Tennessee (14982) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457671380
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NamePAUL TIMOTHY TIDMORECredential: NP
Location Address2210 SUTHERLAND AVE STE 110Knoxville, TN 37919-2337
Mailing Address460 Medical Park Dr Ste 106Lenoir City, TN 37772-5782 · (865) 988-4452 · Fax (865) 988-6293
Phone(865) 525-4333
Fax(865) 374-2203
Sole ProprietorNo
Enumeration DateJune 2, 2010
Last NPPES UpdateApril 24, 20242 updates tracked since enumeration
NPPES CertifiedApril 24, 2024
✔ NPI 1457671380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in TN · 14982
2210 SUTHERLAND AVE STE 110, Knoxville, TN 37919
Open in Google Maps ↗

Other Identifiers 1

Medicaid1523332TN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Timothy Tidmore Np 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.

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.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
95 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37919 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

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

COVENANT MEDICAL GROUP, INC
Durable Medical Equipment & Medical Supplies
2210 SUTHERLAND AVE STE 110
KNOXVILLE, TN 37919
Knox County (865) 525-4333

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Tidmore's NPI number?

The NPI number for Paul Tidmore is 1457671380. It was assigned to this individual provider in the NPPES registry on June 2, 2010.

Where is Paul Tidmore located?

Paul Tidmore practices at 2210 Sutherland Ave Ste 110, Knoxville, TN 37919. The listed phone number is (865) 525-4333.

What is Paul Tidmore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Paul Tidmore enrolled in Medicare?

Yes. Paul Tidmore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Paul Tidmore was last updated on April 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.