Individual provider Active NPI

Katherine Kelly Lidz, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Palm City, FL
National Provider Identifier
1861809998
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9424269 Issued in FL
Practice address
6520 SW Thistle Ter
Palm City, FL 34990-3857
Phone
(803) 619-9846
NPI assigned
Jul 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP9424269 FL Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN9424269 FL

Addresses

Primary practice location

6520 SW Thistle Ter
Palm City, FL 34990-3857

Mailing address

1983 Newberry LN
Tega Cay, SC 29708-8438
Phone (803) 619-9846

Other practice location 1

109 N 12th St
Brooklyn, NY 11249-1002
Phone (813) 619-9846

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9424269FLMDPsychiatric/Mental Health Registered Nurse
ARNP9424269FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rivia Medical PLLC CurrentSince Apr 23, 2023 Accepting new patients
K Lidz NP in Psychiatry PLLC Psychiatric/Mental Health CurrentSince Dec 22, 2024 Accepting new patients

Locations

2125 Biscayne Blvd
Fl 3
Miami, FL 33137

109 N 12th St
Brooklyn, NY 11249
Phone (347) 765-0904

274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1861809998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 NEWBERRY LN",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297088438",
            "telephone_number": "803-619-9846",
            "fax_number": "803-913-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 SW THISTLE TER",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903857",
            "telephone_number": "803-619-9846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112491002",
            "country_code": "US",
            "telephone_number": "813-619-9846",
            "fax_number": "803-913-5275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIDZ",
        "first_name": "KATHERINE",
        "middle_name": "KELLY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9424269",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "RN9424269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.