Avian D Kidd, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M1829 Issued in TX

Practice address

2900 McKinnon St # 502
Dallas, TX 75201

Phone

(972) 505-1584

Fax

(844) 582-3627

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)
• Healthtexas Provider Network - Waxahachie Surgical Specialist, LLP

  • Surgery Physician
  • Waxahachie, TX
  • NPI 1871598458
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1629179312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 MCKINNON ST # 502",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752011064",
            "telephone_number": "972-505-1584",
            "fax_number": "844-582-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MCKINNON ST # 502",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75201",
            "telephone_number": "972-505-1584",
            "fax_number": "844-582-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 Mckinney Avenue",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75204",
            "country_code": "US",
            "telephone_number": "214-643-6185 x6067",
            "fax_number": "214-643-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "AVIAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M1829",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175473105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X0055",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175473101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175473104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S3699",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175473103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BR081",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawit Kidane
• Ezana Kidane
• Milla Kidane
• Yordanos Ghebremicaheal Kidane, RPH
• Kidd Medical Concepts PLLC
• Jocelyn Denise Kidd, D.D.S
• Kimberly Kidd
• Mehgan Kidd, MD
• Michaela Angelea Kidd, CAA
• Mary Kidder, LCSW

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.