NPIMap

Individual provider Active NPI

Richard Kidd

  • Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1629456983
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
85279 Issued in SC
Practice address
602 Main Street
Summerville, SC 29483-6627
Phone
(843) 876-2121
NPI assigned
May 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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 85279 SC Primary

Addresses

Primary practice location

602 Main Street
Summerville, SC 29483-6627

Mailing address

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

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
I20150813010392 SC Practitioner - Nurse Practitioner 1052305059 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Family Care IncGroup PAC ID 4587557731, shared by 3 NPIs, 81 clinicians

Practice addresses (Care Compare)

167 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2000 1St Ave
Summerville, SC 29486-0408
Phone (843) 876-7930

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone (843) 792-1414

8992 University Blvd
Suite 300
North Charleston, SC 29406-8104
Phone (843) 876-8555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.96 of 100Reported as group
Quality
89.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19496SCMDObstetrics & Gynecology Physician
85279SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care Inc CurrentSince Sep 1, 2015 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol Nurse Practitioner CurrentSince Jul 15, 2022 Accepting new patients
Carolina Family Care, Inc Current Accepting new patients
Carolina Family Care, Inc CurrentSince Sep 1, 2015 Accepting new patients
Carolina Family Care, Inc Past Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2060 Sam Rittenberg Blvd
Charleston, SC 29407
Phone (843) 792-2020

490 Martello Dr
Charleston, SC 29412
Phone (843) 762-4963

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

1440 Ben Sawyer Blvd
Ste 1109
Mt Pleasant, SC 29464
Phone (843) 876-8333

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

602 N Main St
Summerville, SC 29483
Phone (843) 876-2121

2000 1st Ave
Summerville, SC 29486
Phone (843) 876-7930

Interoperability endpoints

  • Direct secure messaging: rkidd32472@direct.musc.edu

Organizations & group practices 6

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": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1629456983",
    "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": "602 MAIN STREET",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836627",
            "telephone_number": "843-876-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-07",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "85279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.