Individual provider Active NPI

Laura E Kidder, APRN

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1619868908
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11040862 Issued in FL
Practice address
9310 Old Kings Rd S Ste 1303
Jacksonville, FL 32257-8100
Phone
(904) 900-3472
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11040862 FL Primary

Addresses

Primary practice location

9310 Old Kings Rd S Ste 1303
Jacksonville, FL 32257-8100

Mailing address

9310 Old Kings Rd S Ste 1303
Jacksonville, FL 32257-8100
Phone (904) 900-3472

Other practice location 1

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkidder391286@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007001661 FL Practitioner - Nurse Practitioner 6305343468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

  • Mayo Clinic Hospital, Jacksonville, FL, CCN 100151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11040862FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Sep 29, 2025 Accepting new patients
Cornerstone Family Medicine LLC CurrentSince Sep 28, 2025 Accepting new patients
Mayo Clinic Jacksonville Current Accepting new patients
Mayo Clinic Jacksonville CurrentSince Sep 29, 2025 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

9310 Old Kings Rd S
Ste 1303
Jacksonville, FL 32257
Phone (904) 900-3472

Interoperability endpoints

  • Direct secure messaging: lkidder391286@ehrdirect.mayoclinicmsg.org
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10036363

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1619868908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 OLD KINGS RD S STE 1303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578100",
            "telephone_number": "904-900-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 OLD KINGS RD S STE 1303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578100",
            "telephone_number": "904-900-3472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11040862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkidder391286@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.