Individual provider Active NPI

Kristen Alyce Lidgett

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1093209744
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009379 Issued in CA
Practice address
9908 Brimhall Rd Ste 101
Bakersfield, CA 93312-3179
Phone
(661) 324-4747
Fax
(661) 321-4749
NPI assigned
Jun 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009379 CA Primary

Addresses

Primary practice location

9908 Brimhall Rd Ste 101
Bakersfield, CA 93312-3179

Mailing address

9908 Brimhall Rd Ste 101
Bakersfield, CA 93312-3179
Phone (661) 324-4747

Other identifiers 1

IdentifierTypeStateIssuer
95-2707101MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181022001131 CA Practitioner - Nurse Practitioner 5799038717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mohawk Medical and Associates IncGroup PAC ID 8224295100, 4 clinicians

Practice addresses (Care Compare)

9908 Brimhall Rd
Bakersfield, CA 93312-3178
Phone (661) 321-3288

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mohawk Medical & Associates, Inc. CurrentSince Dec 10, 2021 Accepting new patients
Clinica Sierra Vista PastSince Mar 7, 2021 Accepting new patients
Bakersfield Memorial Hospital PastSince Dec 10, 2021 Accepting new patients
Clinica Sierra Vista PastSince Dec 1, 2019 Accepting new patients

Locations

9908 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 321-3288

9908 Brimhall Rd
Ste 101
Bakersfield, CA 93312
Phone (661) 324-4747

9914 Brimhall Rd
Bakersfield, CA 93312

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1093209744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9908 BRIMHALL RD STE 101",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933123179",
            "telephone_number": "661-324-4747",
            "fax_number": "661-321-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9908 BRIMHALL RD STE 101",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933123179",
            "telephone_number": "661-324-4747",
            "fax_number": "661-321-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDGETT",
        "first_name": "KRISTEN",
        "middle_name": "ALYCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-17",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95-2707101",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.