Active NPI
Jason Joseph Kidd, LCSW
- Clinical Social Worker
- San Antonio, TX
National Provider Identifier
1760745335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C008917
- Practice address
- 3551 Roger Brooke Dr
San Antonio, TX 78234-4504 - Phone
- (210) 539-9582
- NPI assigned
- Jun 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C008917 | NC | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Phone (210) 916-5792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C008917 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1760745335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-5792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-539-9582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "JASON",
"middle_name": "JOSEPH",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-19",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C008917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.