Francis E Kidwell III, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108502 Issued in FL

Practice address

2010 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1352

Phone

(850) 862-3000

Fax

(850) 862-1621

NPI assigned

Jul 21, 2006

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 names 1

• Kip Kidwell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: francis.kidwell.1@9582.direct.athenahealth.com

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1215958848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-863-3000",
            "fax_number": "850-862-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471352",
            "telephone_number": "850-862-3000",
            "fax_number": "850-862-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "FRANCIS",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIP",
            "last_name": "KIDWELL",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hannah Elaine Kettle-Church, LPN
• Dawn Kimball Key, LMHC
• Sikandar Khan, MD
• Jessica Lauren Kibe, BCBA
• Tara Nicole Kidd, MSN, APRN, PMHNP-BC
• Lawrence P King, M.D.
• Melissa McGuinn King, M.D.
• Nancy King, RD
• Brittney Marie Kinnaman-Lechuga, RBT
• Kith & Kin ABA LLC

• Physician Assistant in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.

Verify at the official NPI Registry.