Individual provider Active NPI

James Michael Kidder, M.D.

  • Pediatrics Physician
  • Lexington, NC
National Provider Identifier
1447432166
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2009-01301 Issued in NC
Practice address
13 Medical Park Dr
Lexington, NC 27292-6768
Phone
(336) 249-4911
Fax
(336) 249-1782
NPI assigned
Dec 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2009-01301 NC Primary

Addresses

Primary practice location

13 Medical Park Dr
Lexington, NC 27292-6768

Mailing address

PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2011

Other practice location 1

1439 E Cone Blvd
Greensboro, NC 27405-4533
Phone (833) 904-2273

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090822000201 NC Practitioner - Pediatric Medicine 3971657164 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-01301NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cityblock Medical Practice, P.a. CurrentSince Jul 1, 2023 Accepting new patients

Locations

4444 The Plaza
Unit 18
Charlotte, NC 28215

1439 E Cone Blvd
Greensboro, NC 27405
Phone (336) 375-6104

495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (215) 588-1676

Interoperability endpoints

  • Direct secure messaging: james.kidder.1@27775.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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1447432166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 MEDICAL PARK DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926768",
            "telephone_number": "336-249-4911",
            "fax_number": "336-249-1782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1439 E Cone Blvd",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274054533",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-01301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.