Jacob Wayne Kidd, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S. 1100868 Issued in OH

Practice address

2600 Victory Pkwy
Cincinnati, OH 45206-1711

Phone

(513) 751-7747

Fax

(513) 751-8107

NPI assigned

Dec 23, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shawnee Mental Health Center, Inc.

  dba DBA Shawnee Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Portsmouth, OH
  • NPI 1063982924
  NPD (past)
• Shawnee Mental Health Center, Inc.

  dba Shawnee Family Health Center

  • Clinic/Center
  • Portsmouth, OH
  • NPI 1730682733
  NPD (past)
• Shawnee Mental Health Center, Inc.

  dba DBA Shawnee Family Health Center

  • Federally Qualified Health Center (FQHC)
  • West Union, OH
  • NPI 1750851622
  NPD (past)

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1346661055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 KENSINGTON LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451566",
            "telephone_number": "513-205-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061711",
            "telephone_number": "513-751-7747",
            "fax_number": "513-751-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "JACOB",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S. 1100868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Christine Kichler, PHD
• Alexandra D Kidd
• Alishia Nicole Kidd, CDCA
• Brandy Kidd
• Diane Kidd, LSW
• Jamie Kidd, APRN, FNP-C
• Shelia Kidd
• Stacey Lee Kidd, WHNP-BC
• Abigail Kidder
• Michael Kidder, CDCA

• Social Worker in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.