Jayne Penelope Kidder, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0002003 Issued in OH

Practice address

127 Woodside Ave SE
North Canton, OH 44720-3236

Phone

(513) 509-2579

Fax

(234) 209-9010

NPI assigned

Jun 7, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• J. Penelope Kidder Professional name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Infinity Counseling, LLC

  • Mental Health Counselor
  • Brunswick, OH
  • NPI 1386019438

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1972297471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WOODSIDE AVE SE",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447203236",
            "telephone_number": "513-509-2579",
            "fax_number": "234-209-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 WOODSIDE AVE SE",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447203236",
            "telephone_number": "513-509-2579",
            "fax_number": "234-209-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "JAYNE",
        "middle_name": "PENELOPE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "0002003",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "0002003",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "0002003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J.",
            "last_name": "KIDDER",
            "middle_name": "PENELOPE",
            "credential": "LPCC-S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Candy Kessler
• Jacob A Ketler, LPTA
• Zetta L Keys
• Heidi J Khalil, PTA
• Laura Marie Kidd, PC
• Stephanie A Kiefer, PT
• Sylvia Kiefer, OTR/L
• Danielle S. Kiko, M.D.
• Mary Kimberlin
• Camryn M Kimble, PTA

• Professional Counselor in North Canton, OH
• Providers in North Canton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.