Active NPI
Joelle Marie Kidder, PA-C
- Physician Assistant
- Midlothian, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110007875
- Practice address
- 11020 Hull Street Rd
Midlothian, VA 23112-3200 - Phone
- (804) 744-6310
- NPI assigned
- Aug 23, 2014
- Last updated
- Aug 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110007875 | VA | Primary |
Addresses
Primary practice location
11020 Hull Street Rd
Midlothian, VA 23112-3200
Mailing address
5000 Cox Rd
Glen Allen, VA 23060-9263
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | urgentcaresmhd@sjhhandhmg.allscriptsdirect.net | ||
| Direct Messaging Address | VAExchange@patientfirstclinics.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110007875 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patient First Richmond Medical Group PLLC | Current | Accepting new patients | |
| Patient First Richmond Medical Group PLLC | Current | Accepting new patients |
Locations
6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087
5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355
601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396
11020 Hull Street Rd
Midlothian, VA 23112
Phone (804) 744-6310
Interoperability endpoints
- vaexchange@patientfirstclinics.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Glen Allen, VA
- NPI 1689603748
DC
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
VA
-
- Urgent Care Clinic/Center
- Fairfax, VA
- NPI 1588018881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628467200000",
"number": "1033519392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 COX RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230609263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11020 HULL STREET RD",
"city": "MIDLOTHIAN",
"state": "VA",
"postal_code": "231123200",
"telephone_number": "804-744-6310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDDER",
"first_name": "JOELLE",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-23",
"last_updated": "2021-08-09",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110007875",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "urgentcaresmhd@sjhhandhmg.allscriptsdirect.net",
"affiliation": "N",
"address_1": "17043 Main St",
"city": "Hesperia",
"state": "CA",
"country_code": "US",
"postal_code": "923456055",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "VAExchange@patientfirstclinics.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "11020 Hull Street Rd",
"city": "Midlothian",
"state": "VA",
"country_code": "US",
"postal_code": "231123200",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Midlothian, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.