Charles Alexander Kidd, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56894 Issued in TN

Practice address

207 Elk Ave S
Fayetteville, TN 37334-3051

Phone

(931) 433-2551

Fax

(931) 438-0069

NPI assigned

Jun 17, 2015

Last updated

Jun 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

East Tennessee State University Quillen College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HH Health System - Lincoln IncGroup PAC ID 3971987900, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lincoln Medical Home Health and Hospice Home health agency, Fayetteville, TN, CCN 447247
• Quality First Home Care Home health agency, Columbia, TN, CCN 447184
• Lincoln Medical Center Hospital, Fayetteville, TN, CCN 440102
• Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charleskidd@fmapc.allscriptsdirect.net

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.

• HH Health System - Lincoln Inc

  dba Lincoln Medical Group

  • Specialist
  • Fayetteville, TN
  • NPI 1740914324
  Medicare reassignment Care Compare group NPD
• HH Physician Care-Fayetteville Medical Associates

  • Family Medicine Physician
  • Fayetteville, TN
  • NPI 1225574056
  Medicare reassignment NPD
• HH Health System - Lincoln Inc

  dba Lincoln Medical Home Health and Hospice

  • Home Health Agency
  • Fayetteville, TN
  • NPI 1508590183
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HH Health System - Lincoln Inc

  dba Lincoln Medical Center

  • Rural Acute Care Hospital
  • Fayetteville, TN
  • NPI 1255066460
  Care Compare affiliation
• HH Health System Lincoln

  • Home Health Agency
  • Fayetteville, TN
  • NPI 1942045141
  Care Compare affiliation
• Volunteer Homecare of Middle Tennessee Inc.

  dba Quality First Home Care Inc.

  • Home Health Agency
  • Columbia, TN
  • NPI 1578514717
  Care Compare affiliation
• The Health Care Authority of the City of Huntsville

  dba Huntsville Hospital

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1447221056
  Care Compare affiliation

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1396126165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "address_2": "RESIDENT ENROLLMENT",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-455-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 ELK AVE S",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373343051",
            "telephone_number": "931-433-2551",
            "fax_number": "931-438-0069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 GROVE RD",
            "address_2": "ATT: RESIDENCY COORDINDATOR",
            "address_purpose": "LOCATION",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055611",
            "country_code": "US",
            "telephone_number": "864-455-7844",
            "fax_number": "864-455-7848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "CHARLES",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "38504",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "56894",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "38504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baylee Johnson, FNP
• Heather Ogle Johnson, MEDCCCSLP
• William R Jones, MD
• Laura L Kelsey, RN, BSN, IBCLC
• Sarah Nichole Kervin, APRN, AGACNP-BC
• Carrington Bain Kite
• Michael W Knight, CRNA
• Jinson Eugene Knott
• William D Layman, MD
• Lend a Hand Supported Living

• Internal Medicine Physician in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.
• 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.