Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle Louise Tidd, PA

Individual provider Physician Assistant · NPI 1194126813

Michelle Louise Tidd, PA is a Physician Assistant in Charlotte, North Carolina. Qualified in 2014, 12 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia, North Carolina and South Carolina.

Years since qualifying
12
Licensed in
GA, NC, SC
In the registry since
2014
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1918 Randolph Rd Ste 130
Charlotte, NC 28207-1107
Phone: (704) 316-6005
Fax: (704) 316-6006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 840 Pine St, Macon, GA 31201-2100 — (478) 633-8682
  • 449 N Wendover Rd Ste A, Charlotte, NC 28211-1064 — (704) 316-6005

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-11355 (NC)
Physician Assistant Taxonomy 363A00000X (GA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 2865 (SC)

Record details

NPI number1194126813
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 12, 2014
Last updated in NPPESAugust 26, 2025
Certification dateAugust 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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