Active NPI
Yancie John Kidd, AU.D.
- Audiologist
- Rexburg, ID
National Provider Identifier
1821049784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AUD-1081
- Practice address
- 218 Dividend Dr
Suite 2
Rexburg, ID 83440-3556 - Phone
- (208) 359-2727
- Fax
- (208) 359-5468
- NPI assigned
- May 15, 2006
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | AUD-1081 | ID | Primary |
Addresses
Primary practice location
218 Dividend Dr
Suite 2
Rexburg, ID 83440-3556
Mailing address
635 E 2ND N
Saint Anthony, ID 83445-1612
Phone (208) 403-5450
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AUD-1081 | ID | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Hearing and Audiology LLC | Audiologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Audiologist
- Idaho Falls, ID
- NPI 1053719047
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269907200000",
"number": "1821049784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 E 2ND N",
"city": "SAINT ANTHONY",
"state": "ID",
"postal_code": "834451612",
"telephone_number": "208-403-5450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 DIVIDEND DR",
"address_2": "SUITE 2",
"city": "REXBURG",
"state": "ID",
"postal_code": "834403556",
"telephone_number": "208-359-2727",
"fax_number": "208-359-5468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "YANCIE",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2010-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "ID",
"license": "AUD-1081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.