TIDWELL HEALTHCARE, LLC (NPI# 1023430741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023430741 |
| Entity Type | Organization |
| Organization Name | TIDWELL HEALTHCARE, LLC |
| Other Organization Name | TIDWELL LIVING CENTER |
| Practice Address |
900 Ranchwood Dr Wilburton OK 74578-3630 |
| Practice Telephone | 9184655020 |
| Practice Fax Number | 9184655007 |
| Mailing Telephone | 9184655020 |
| Mailing Fax Number | 9184655007 |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2015-12-31 |
| Authorized Official Name | MELISSA C TIDWELL (OWNER) |
| Authorized Official Telephone | 9184655020 |
| Authorized Official Credential | RN, MHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | NH3903-3903 | OK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200522320A | 05 |
| Other Name | Type Code |
|---|---|
| Tidwell Living Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | TIDWELL HEALTHCARE, LLC | 225 W Main St, Wilburton, OK 74578 |
| Street Address |
900 RANCHWOOD DR |
| City | WILBURTON |
| State | OK |
| Zip Code | 74578-3630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174769673 | Hallmark Medical, LLC | Durable Medical Equipment & Medical Supplies | 900 Ranchwood Dr, Wilburton, OK 74578-3630 | 2009-01-05 |
| 1952738163 | Latimer County Hospital Retirement Center, LLC | Skilled Nursing Facility | 900 Ranchwood Dr, Wilburton, OK 74578-3630 | 2013-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619539541 | Keli Jo Spears | Counselor | 10975 Sw Hwy 1, Wilburton, OK 74578 | 2019-07-01 |
| 1932564523 | Jennifer Roberts | Behavioral Analyst | 101 Blassingame Ct, Wilburton, OK 74578 | 2015-12-23 |
| 1285988683 | Cheryl Lin Kennon | Contractor | 320 Medlock St, Wilburton, OK 74578 | 2012-11-07 |
| 1578783684 | Debra Ann Jacobs | Day Training/Habilitation Specialist | 312 Se 5th Street, Wilburton, OK 74578 | 2007-04-30 |
| 1891817664 | Rustling Winds Inc | Counselor | 211 West Main, Wilburton, OK 74578 | 2007-04-04 |
| 1427143429 | Ricardo Mariano Valbuena | Family Medicine | 1107 West Main Street, Wilburton, OK 74578 | 2006-10-04 |
| 1780676320 | Home Care Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 9128 Nw Hwy 2, Wilburton, OK 74578 | 2005-08-19 |
| 1467733535 | Wilburton Public Schools | Local Education Agency (LEA) | 1201 W Blair Ave, Wilburton, OK 74578-2009 | 2011-09-02 |
| 1154617405 | Laurie Lee Franco | Case Management | 508 Nw 4th St, Wilburton, OK 74578-2216 | 2011-06-24 |
| 1386070886 | Tennie I Clark | Case Manager/Care Coordinator | 805 W Durant Ave, Wilburton, OK 74578-2243 | 2013-09-17 |
| Find all providers in zip 74578 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881802569 | Eastern Oklahoma Nursing Homes, Inc. | Nursing Facility/Intermediate Care Facility | 103 Sw 9th St, Wilburton, OK 74578-3604 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455696 | Global Higher Call Nursing, LLC | Nursing Facility/Intermediate Care Facility | 407 Whitebird St, Quapaw, OK 74363-0912 | 2020-07-23 |
| 1336641786 | Sherri Geanette Hilburn | Nursing Facility/Intermediate Care Facility | 225 N. Broadway, Carnegie, OK 73015 | 2018-03-01 |
| 1750891149 | Anadarko Nursing & Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 300 West Washington, Anadarko, OK 73005 | 2017-10-11 |
| 1659773778 | First Choice Home Medical Inc | Nursing Facility/Intermediate Care Facility | 720 N Galena Ave, Geary, OK 73040-1501 | 2014-09-19 |
| 1467852244 | Jlg Healthcare LLC | Nursing Facility/Intermediate Care Facility | 811 W Elk, Duncan, OK 73533-1196 | 2014-08-28 |
| 1720326622 | Integris Rehab LLC | Nursing Facility/Intermediate Care Facility | 14145 S 220th East Ave, Coweta, OK 74429-6269 | 2013-01-28 |
| 1053617761 | Colonial Park Healthcare Center LLC | Nursing Facility/Intermediate Care Facility | 600 W Frontage Rd, Okemah, OK 74859-6433 | 2011-01-28 |
| 1851562136 | Thomas Health and Rehabilitation LLC | Nursing Facility/Intermediate Care Facility | 601 East Frisco Street, Thomas, OK 73669 | 2008-03-14 |
| 1770768566 | Cox Building Company, Inc. | Nursing Facility/Intermediate Care Facility | 3501 W Washington St, Broken Arrow, OK 74012-9196 | 2007-12-31 |
| 1477745834 | Rehabcare | Nursing Facility/Intermediate Care Facility | 300 Rockefeller, Muskogee, OK 74401-5235 | 2007-08-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.