Andrea Kidd, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

032712 Issued in NY

Practice address

500 N Columbus Ave
Mount Vernon, NY 10552-1335

Phone

(914) 266-3796

Fax

(914) 840-1397

NPI assigned

Nov 16, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Andrea Patterson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

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  • NPI 1346530169
  NPD

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1871007542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4134 ADALRIC DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N COLUMBUS AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105521335",
            "telephone_number": "914-266-3796",
            "fax_number": "914-840-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "ANDREA",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11318",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "032712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "PATTERSON",
            "credential": "M.A., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sharon Kerr
• Sheril Kerr, LPN
• Anwar Ameer Khan
• Rafeeza Khan, PHARMD
• Zareen R Khan, MD
• Stephen Bruce Kildare, PSYD
• Chung Eun P Kim, M.D.
• Elizabeth Kim
• Kyung H Kim, M.D
• Tai Ho Kim, R.PH.

• Speech-Language Pathologist in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.