Individual provider Active NPI

Christina Mae Kidd

  • Pediatrics Physician
  • Oklahoma City, OK
National Provider Identifier
1861098972
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43714 Issued in OK
Practice address
1200 Childrens Ave Ste 14000
Oklahoma City, OK 73104-4637
Phone
(405) 271-4401
NPI assigned
Dec 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43714 OK Primary

Addresses

Primary practice location

1200 Childrens Ave Ste 14000
Oklahoma City, OK 73104-4637

Mailing address

1118 McConnell Dr
Yukon, OK 73099-3310
Phone (405) 227-8555

Other practice location 1

800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018
Phone (405) 271-2316

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
43714OKMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1861098972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 MCCONNELL DR",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730993310",
            "telephone_number": "405-227-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE STE 14000",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Stanton L Young Blvd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045018",
            "country_code": "US",
            "telephone_number": "405-271-2316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "CHRISTINA",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-05",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "43714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.