Kidmed PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

KIDMED PLLC

Practice address

1165 Cedar Point Blvd Ste F
Cedar Point, NC 28584-1030

Phone

(252) 364-4690

Fax

(252) 606-4325

NPI assigned

Jul 19, 2024

Organization subpart

No

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

Authorized official

Name

Kelly Rae Durham, PA-CNPI 1326093956

Title

President

Phone

(910) 340-1521

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Rae Durham, PA C

  • Physician Assistant
  • Cedar Point, NC
  • NPI 1326093956
  NPD Authorized official
• Angela Lee Smith

  • Nurse Practitioner
  • Cedar Point, NC
  • NPI 1356289813
  NPD (past)

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763510400000",
    "number": "1306684642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E IVYBRIDGE DR",
            "city": "HUBERT",
            "state": "NC",
            "postal_code": "285395401",
            "telephone_number": "910-340-1521",
            "fax_number": "252-606-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 CEDAR POINT BLVD STE F",
            "city": "CEDAR POINT",
            "state": "NC",
            "postal_code": "285841030",
            "telephone_number": "252-364-4690",
            "fax_number": "252-606-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDMED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-340-1521",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther L Homer, OCULARIST
• James Ellsworth Homer, OCULARIST
• Daniel John Houskamp, MD
• Melinda Kay Hunsinger
• Jarrett Darrah, D.D.S., PLLC (Anchor Dental)
• Steven Michael Kriss, D.O.
• Alexandra V Leewright, MPT
• Joanne D Liles, NP
• John Thomas Manning, NP
• Leigh Anne Maples, PT

• Physician Assistant in Cedar Point, NC
• Providers in Cedar Point, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.