Individual provider Active NPI

Milton B Kidd III, OD

  • Optometrist
  • Franklin, LA
National Provider Identifier
1902996911
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
753-087T Issued in LA
Practice address
1500 Northwest Blvd
Franklin, LA 70538-3442
Phone
(337) 828-3651
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 753-087T LA Primary

Addresses

Primary practice location

1500 Northwest Blvd
Franklin, LA 70538-3442

Mailing address

1500 Northwest Blvd
Franklin, LA 70538-3442
Phone (337) 828-3651

Other identifiers 2

IdentifierTypeStateIssuer
LA053OtherLABLUE CROSS MORGAN CITY
1170534MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100723000654 LA Practitioner - Optometry 4183712573 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
753-087TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidd and Associcates LLC Optometrist CurrentSince Oct 1, 1990 Accepting new patients

Locations

1500 Northwest Blvd
Franklin, LA 70538
Phone (337) 828-3651

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1902996911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NORTHWEST BLVD",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705383442",
            "telephone_number": "337-828-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NORTHWEST BLVD",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705383442",
            "telephone_number": "337-828-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "MILTON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "753-087T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MORGAN CITY",
            "identifier": "LA053",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1170534",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, LA

Sources for this page

Verify at the official NPI Registry.