Elisabeth Anne Kidd, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-06692 Issued in NC

Practice address

3643 N Roxboro St
Durham, NC 27704-2702

Phone

(919) 470-8490

Fax

(919) 470-8469

NPI assigned

Sep 8, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ekidd247076@direct.medicine.duke.edu

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1013464999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-8490",
            "fax_number": "919-470-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042702",
            "telephone_number": "919-470-8490",
            "fax_number": "919-470-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "ELISABETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-06692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Y-Lan Khuong, MD
• Sanskriti Khurana
• Radhika Khwaja, M.D.
• Mays Ahmed Ali Khweileh, MD
• Gina M Kicinski
• Kiddle Prep School, Inc
• Kids N Heart
• Kidspeace National Centers of North America Inc
• Kidspeace National Centers of North America, Inc
• Kidspeace National Centers of North America, Inc.

• Medical Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.