Individual provider Active NPI

Christina Kidd, NP-C

  • Nurse Practitioner
  • Farmville, NC
National Provider Identifier
1306469549
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5014736 Issued in NC
Practice address
3485 N Main St
Farmville, NC 27828-1466
Phone
(252) 753-3193
NPI assigned
May 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 5014736 NC Primary

Addresses

Primary practice location

3485 N Main St
Farmville, NC 27828-1466

Mailing address

3485 N Main St
Farmville, NC 27828-1466
Phone (252) 753-3193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220404002507 NC Practitioner - Nurse Practitioner 5698161404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Farmville Internal Medicine PAGroup PAC ID 8325037575, 4 clinicians

Practice addresses (Care Compare)

3485 N Main St
Farmville, NC 27828-1466
Phone (252) 753-3193

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Farmville Internal Medicine PA CurrentSince Nov 28, 2021 Accepting new patients

Locations

3485 North Main St
Farmville, NC 27828
Phone (252) 753-3193

Interoperability endpoints

  • Direct secure messaging: christina.kidd.1@32498.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1306469549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 N MAIN ST",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281466",
            "telephone_number": "252-753-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 N MAIN ST",
            "city": "FARMVILLE",
            "state": "NC",
            "postal_code": "278281466",
            "telephone_number": "252-753-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "CHRISTINA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmville, NC

Sources for this page

Verify at the official NPI Registry.