Micah Kidd

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

RN664312 Issued in PA

Practice address

420 S 5TH Ave
West Reading, PA 19611-2143

Phone

(484) 628-7115

NPI assigned

Jun 19, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1922783869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E MAIN ST",
            "city": "KUTZTOWN",
            "state": "PA",
            "postal_code": "195301517",
            "telephone_number": "484-258-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "MICAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "PA",
            "license": "RN664312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suravi Khanal
• Mansi Khariwal
• Imran Khokhar, MD
• Mohammad Ali Khoshnoodi, M.D.
• Jasdeep K Khurana, M.D
• Jody Kilpatrick
• Esther Kim, DO
• Eunjung Kim, M.D.
• Miyu Kinoshita
• Tanya Flegeance Kirby, MD

• Gerontology Clinical Nurse Specialist in West Reading, PA
• Providers in West Reading, PA by specialty
• Gerontology Clinical Nurse Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.