Individual provider Active NPI

Jordan Kidwell

  • Social Worker
  • Canal Winchester, OH
National Provider Identifier
1891640827
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2410777 Issued in OH
Practice address
57 W Waterloo St Ste 103
Canal Winchester, OH 43110-1180
Phone
(614) 321-4010
NPI assigned
Mar 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2410777 OH Primary

Addresses

Primary practice location

57 W Waterloo St Ste 103
Canal Winchester, OH 43110-1180

Mailing address

57 W Waterloo St Ste 103
Canal Winchester, OH 43110-1180
Phone (614) 321-4010

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
S.2410777OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
3D Pathways, LLC PastSince May 2, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1891640827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W WATERLOO ST STE 103",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431101180",
            "telephone_number": "614-321-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W WATERLOO ST STE 103",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431101180",
            "telephone_number": "614-321-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2410777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.