Jason S. Kidd, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

01023 Issued in WV

Practice address

924 Liberty Street
West Milford, WV 26451

Phone

(304) 745-4568

Fax

(304) 326-3700

NPI assigned

Apr 12, 2007

Last updated

Jul 16, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care of West Virginia, Inc.Group PAC ID 0446232987, shared by 74 NPIs, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations (25 of 26)

Interoperability endpoints

• Direct secure messaging: jason.kidd.1@4803.direct.athenahealth.com

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.

• Community Care of West Virginia, Inc.

  dba Community Care of Bridgeport

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, WV
  • NPI 1063808418
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba CareXpress of Weston

  • Federally Qualified Health Center (FQHC)
  • Weston, WV
  • NPI 1073944658
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Braxton County Middle School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1104175058
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Buckhannon-Upshur High School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1104177674
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba CareXpress of Buckhannon

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1114277050
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Community Care of Marlinton

  • Federally Qualified Health Center (FQHC)
  • Marlinton, WV
  • NPI 1164653457
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Robert C. Byrd High Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Clarksburg, WV
  • NPI 1356780639
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Marlinton Middle School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Marlinton, WV
  • NPI 1386083673
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Braxton County High School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1396096863
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Davis Elementary Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Gassaway, WV
  • NPI 1447699723
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Nutter Fort Intermediate Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Nutter Fort, WV
  • NPI 1477992915
  Medicare reassignment NPD
• Community Care of West Virginia, Inc.

  dba Big Otter Elementary School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Duck, WV
  • NPI 1619103041
  Medicare reassignment NPD

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

• United Hospital Center, Inc

  • General Acute Care Hospital
  • Bridgeport, WV
  • NPI 1184606600
  Care Compare affiliation

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1093939183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "ROCK CAVE",
            "state": "WV",
            "postal_code": "262340217",
            "telephone_number": "304-924-6262",
            "fax_number": "304-924-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 LIBERTY STREET",
            "city": "WEST MILFORD",
            "state": "WV",
            "postal_code": "26451",
            "telephone_number": "304-745-4568",
            "fax_number": "304-326-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JASON",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010365",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Care of West Virginia, Inc. (West Milford Elementary School Wellness Center)
• Melissa S Dodrill, M.D.
• Matya Drennen, FNP-BC
• Kelly W Dunavant, DO
• Chris N Kennedy, DO
• Christy L Lucas, PA-C
• Deana Mae Morrison Fernandez, D.C.
• Christina L Nolte, PAC
• Lori Romeo
• Stephanie Marie Smith, RN, MSN, NP-C

• Medical Physician Assistant in West Milford, WV
• Providers in West Milford, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.