MRS. ELISABETH ANNE KIDD (NPI# 1013464999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013464999 |
| Entity Type | Individual |
| Full Name | MRS. ELISABETH ANNE KIDD |
| Credential | PA-C |
| Practice Address |
3643 N Roxboro St Durham NC 27704-2702 |
| Practice Telephone | 9194708490 |
| Practice Fax Number | 9194708469 |
| Mailing Telephone | 9194708490 |
| Mailing Fax Number | 9194708469 |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-06692 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3643 N ROXBORO ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033113899 | Nirmish Shah | Internal Medicine | 3643 N Roxboro St, Durham, NC 27704-2702 | 2005-06-09 |
| 1548872633 | Christopher James Rogge | Nurse Anesthetist, Certified Registered | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-08-19 |
| 1801404579 | Grace L Johnson | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-07-20 |
| 1174147102 | Kaitlyn Elizabeth Cockerham | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-06-05 |
| 1306466859 | Keri Laurelle Konstant | Registered Nurse | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-04-24 |
| 1194351262 | Deidre Pelletier | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-03-20 |
| 1720618812 | Elizabeth Parker Sulentic | Nurse Practitioner | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-01-17 |
| 1265079131 | Melinda Yvonne House | Nurse Practitioner | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-12-10 |
| 1427607811 | Grace Amy Revenaugh Dreyer | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-09-09 |
| 1841848934 | Ann Mei Lin | Hospitalist | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-08-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
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| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083197651 | Erika Cummings | Physician Assistant | 40 Medicine Circle Clinic 1l Duke South Clinic Bldg, Durham, NC 27710-2102 | 2018-09-10 |
| 1396237566 | Sarah Elizabeth Beatty | Physician Assistant | 1317 Southpoint Crossing Dr, Durham, NC 27713 | 2018-06-04 |
| 1225548704 | Lindsey Anna Rowe | Physician Assistant | 2301 Erwin Road Duke North Suite 2600, Room 2607a, Durham, NC 27710-0001 | 2017-10-10 |
| 1801316831 | Stefanie Nikoloas Xenakis | Physician Assistant | 2400 Broad St Ste 1, Durham, NC 27704-2662 | 2017-06-21 |
| 1861842700 | Kelly Michelle Young | Physician Assistant | 2424 Erwin Rd Ste 201, Durham, NC 27705-3825 | 2016-06-21 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1033589577 | Andrew David Mcgraw | Physician Assistant | Duke University Medical Center Emergency, 2nd Floor 2301 Erwin Road Durham, Nc 27710, Durham, NC 27710-4699 | 2015-09-27 |
| 1093145443 | Catherine Casey Mcknight | Physician Assistant | 3458 Duke University Medical Center, Durham, NC 27710 | 2013-11-21 |
| 1013343490 | Carolyn Chyu Tashie | Physician Assistant | Duke Cancer Center 20 Duke Medicine Circle Clinic 3-2, Durham, NC 27710-4699 | 2013-09-18 |
| 1477817203 | Andrew Robert Macknair | Physician Assistant | 4225 Larchmont Rd, Apt 1021, Durham, NC 27707-5962 | 2012-06-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.