Individual provider Active NPI

Katherine Kidde

  • Certified Registered Nurse Anesthetist
  • Oceanside, CA
National Provider Identifier
1104224773
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
660518 Issued in CA
Practice address
200 Mercy Circle
Oceanside, CA 92055
Phone
(760) 725-1288
NPI assigned
Dec 15, 2014
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95000299 CA
Certified Registered Nurse Anesthetist 367500000X 0024180958 VA
Certified Registered Nurse Anesthetist 367500000X 660518 CA Primary

Addresses

Primary practice location

200 Mercy Circle
Oceanside, CA 92055

Mailing address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210618000430 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204236862 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
660518CAMDCertified Registered Nurse Anesthetist
95000299CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Virginia, LLC CurrentSince Nov 1, 2022 Accepting new patients
Eastern Virginia Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Atlantic Anesthesia, Inc CurrentSince Aug 1, 2021 Accepting new patients
Ambulatory Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 22, 2022 Accepting new patients
NH Camp Pendleton PastSince Jun 15, 2025 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

208 Carmichael Way
Chesapeake, VA 23322
Phone (757) 892-4265

736 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6124

844 Battlefield Blvd N
Chesapeake, VA 23320
Phone (757) 312-6746

541 Sunset Ln
Ste 201
Culpeper, VA 22701
Phone (540) 829-0700

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

830 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-6000

134 Business Park Dr
Virginia Beach, VA 23462
Phone (757) 473-0044

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1104224773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-725-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDE",
        "first_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2025-06-13",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000299",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024180958",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "660518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.