Jessi Blackstock Tidwell, CRNP in Muscle Shoals, AL

Jessi Blackstock Tidwell, CRNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Muscle Shoals, Alabama. Her current practice location is 106 Michigan Blvd, Muscle Shoals, Alabama. You can reach out to her office (for appointments etc.) via phone at (256) 394-0880.

Jessi Blackstock Tidwell is licensed to practice in Alabama (license number 1-162142) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013556356.

Contact Information

	Jessi Blackstock Tidwell, CRNP
	106 Michigan Blvd, Muscle Shoals, AL 35661-2730
	(256) 394-0880
	Not Available

Map and Direction

Provider's Profile

Full Name	Jessi Blackstock Tidwell
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	106 Michigan Blvd, Muscle Shoals, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013556356
Provider Enumeration Date: 01/03/2020
Last Update Date: 08/10/2022

Medicare PECOS Information:

PECOS PAC ID: 3476938606
Enrollment ID: I20220923001027

Medical Identifiers

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

Identifier	Type	State	Issuer
1013556356	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	1-162142 (Alabama)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1-162142 (Alabama)	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. Jessi Blackstock Tidwell allows following entities to bill medicare on her behalf.

Entity Name	Shoals Health Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073851630 PECOS PAC ID: 6800033192 Enrollment ID: O20130503000428

Entity Name	Evolve Behavioral Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316708993 PECOS PAC ID: 9032559521 Enrollment ID: O20240501001270

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. Jessi Blackstock 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
Jessi Blackstock Tidwell, CRNP Po Box 10005, Florence, AL 35631-2005 Ph: (256) 394-0880	Jessi Blackstock Tidwell, CRNP 106 Michigan Blvd, Muscle Shoals, AL 35661-2730 Ph: (256) 394-0880

Reviews and Comments

Nurse Practitioner Nurses in Muscle Shoals, AL

Kristy Miles, CRNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 108 Avalon Ave, Muscle Shoals, AL 35661 Phone: 256-389-9300
Mr. Thaddeus Jason Boughton, ANP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1110 E 6th Street Suite E, Muscle Shoals, AL 35661 Phone: 256-314-2431 Fax: 256-314-2435
Mrs. Melissa Anne Aycock, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 104a Physicians Dr, Muscle Shoals, AL 35661 Phone: 256-383-6070 Fax: 256-381-4022
Jessica Byrd, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 716 State St, Muscle Shoals, AL 35661 Phone: 256-381-6963 Fax: 256-826-0303
Laura Geneva Gilmer, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 210 Avalon Ave, Muscle Shoals, AL 35661 Phone: 256-826-1001 Fax: 256-978-5118
Elizabeth Anne Raper, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2400 Avalon Ave, Suite B, Muscle Shoals, AL 35661 Phone: 256-386-0809 Fax: 256-383-8000
Stacy Davis, ANCC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 503 W State St, Muscle Shoals, AL 35661 Phone: 256-978-4441

Jessi Blackstock Tidwell, CRNP - Medicare Nurse Practitioner in Muscle Shoals, AL