NPIMap

Individual provider Active NPI

Lucina Avila Kidd, D.O.

  • Family Medicine Physician
  • Summerville, SC
National Provider Identifier
1437384278
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94690 Issued in SC
Practice address
87 Springview LN
Summerville, SC 29485-9077
Phone
(843) 876-7979
NPI assigned
May 22, 2009
Last updated
Nov 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94690 SC Primary

Addresses

Primary practice location

87 Springview LN
Summerville, SC 29485-9077

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
68187823MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251230003178 SC Practitioner - Family Practice 9234385857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Family Care IncGroup PAC ID 4587557731, 81 clinicians

Practice addresses (Care Compare)

8471 Resolute Way
North Charleston, SC 29420-7390
Phone (843) 876-8279

8992 University Blvd
North Charleston, SC 29406-8104

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Family Medicine CurrentSince Oct 20, 2025 Accepting new patients
Carolina Family Care, Inc CurrentSince Oct 20, 2025 Accepting new patients
Boulder Community Health Past Accepting new patients
Boulder Community Health PastSince Jul 24, 2022 Accepting new patients
Carolina Family Care, Inc Past Accepting new patients

Locations

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

8992 University Blvd
Ste 300
North Charleston, SC 29406
Phone (843) 876-8279

87 Springview Ln
Summerville, SC 29485
Phone (843) 876-7979

Interoperability endpoints

  • Direct secure messaging: lkidd544777@direct.musc.edu

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1437384278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SPRINGVIEW LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294859077",
            "telephone_number": "843-876-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "LUCINA",
        "middle_name": "AVILA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "94690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68187823",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "87 Springview Ln",
            "city": "Summerville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294859077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.