Family Practice Clinic, PC
NPI 1023380474ActiveOrganization· Nurse Practitioner, Family· Dyersburg, TN
Nurse Practitioner, Family in Dyersburg, Tennessee, registered in NPPES in February 2012. The authorized official on file is Shari P. Tidwell, APRN, FNP-C, Owner/Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1023380474 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 1, 2012 |
| Last updated in NPPES | Nov 20, 2025 |
| Certified by provider | Nov 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 6331 | TN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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