Individual provider Active NPI

Kashira Kidd, RA

  • Radiology Practitioner Assistant
  • Clinton, MD
National Provider Identifier
1487529061
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
License
K0000016 Issued in MD
Practice address
7503 Surratts Rd
Clinton, MD 20735-3358
Phone
(301) 877-4769
NPI assigned
Oct 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 243U00000X K0000016 MD Primary

Addresses

Primary practice location

7503 Surratts Rd
Clinton, MD 20735-3358

Mailing address

7829 S Saginaw Ave
Chicago, IL 60649-5221
Phone (301) 877-4769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
K0000016MDMDRadiology Practitioner Assistant

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1487529061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7829 S SAGINAW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606495221",
            "telephone_number": "301-877-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-877-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "KASHIRA",
        "name_prefix": "Ms.",
        "credential": "RA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology Practitioner Assistant",
            "state": "MD",
            "license": "K0000016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.