Individual provider Active NPI

Loretta Andrews Kidd

  • Community Health Worker
  • Dallas, TX
National Provider Identifier
1083063853
Registry record updated Jun 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
3331 Navajo PL
Dallas, TX 75224-3732
Phone
(214) 643-2646
NPI assigned
Jun 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X TX Primary

Addresses

Primary practice location

3331 Navajo PL
Dallas, TX 75224-3732

Mailing address

3331 Navajo PL
Dallas, TX 75224-3732
Phone (214) 643-2646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1465689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465689600000",
    "number": "1083063853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 NAVAJO PL",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752243732",
            "telephone_number": "214-643-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 NAVAJO PL",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752243732",
            "telephone_number": "214-643-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS KIDD",
        "first_name": "LORETTA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-12",
        "last_updated": "2016-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.