MR. BLAINE MICHAEL KIDD (NPI# 1700493483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700493483 |
| Entity Type | Individual |
| Full Name | MR. BLAINE MICHAEL KIDD |
| Practice Address |
900 N John R Wooden Dr West Lafayette IN 47907-2117 |
| Practice Telephone | 8004977678 |
| Mailing Telephone | 8004977678 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
900 N JOHN R WOODEN DR |
| City | WEST LAFAYETTE |
| State | IN |
| Zip Code | 47907-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770570616 | Gregory A Rowdon | Internal Medicine | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2005-10-05 |
| 1699373837 | Hope Elizabeth Walker | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-10-10 |
| 1245837699 | Mckayla Deborah Tallman | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-10-07 |
| 1295332054 | Samari Jo Thomas | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-10-05 |
| 1184231417 | Samantha Betty Lee Archer I | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-30 |
| 1417564717 | Isabella Hannigan | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-30 |
| 1780291419 | Madison Taylor Stewart | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-27 |
| 1861007718 | Alexis Lillian Branham | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-08 |
| 1568076958 | Abigail Marie Stoy | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-02 |
| 1740894385 | Kennady T Oliver | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285274464 | Christine Michelle Jones | Nurse Practitioner | Lyles-porter Hall 715 Clinic Drive, West Lafayette, IN 47907 | 2020-01-15 |
| 1013415033 | Brianna Johnson | Psychologist | 601 Stadium Mall Drive, Purdue University Student Health Center, 2nd Floor, West Lafayette, IN 47907 | 2018-01-24 |
| 1285095885 | Christina Ellen Manfred | Nurse Practitioner | 601 W. Stadium Ave, West Lafayette, IN 47907 | 2016-03-10 |
| 1265612626 | Anu Subramanian | Speech-Language Pathologist | 500 Oval Drive Purdue University, Dept of Speech Language and Hearing Sciences, West Lafayette, IN 47907 | 2007-11-13 |
| 1720163348 | Andrea Lynn Lopez | Specialist/Technologist | 900 N. University Ave, Room B63, West Lafayette, IN 47907 | 2006-10-25 |
| 1912914680 | Jeanette Stone Leonard | Audiologist | 715 Clinic Drive, Purdue University, West Lafayette, IN 47907 | 2006-08-02 |
| 1447224977 | Lindsey Ann Watson | Specialist/Technologist | 900 N University Dr, Mackey Arena, Room B60, West Lafayette, IN 47907 | 2006-02-13 |
| 1992280960 | Carol Callahan Lancaster | Nurse Practitioner | 601 Stadium Mall Drive, West Lafayette, IN 47907 | 2018-09-26 |
| 1053712570 | Purdue Sports Medicine Wl | Internal Medicine | 900 John R Wooden Drive, Mackey Arena, West Lafayette, IN 47907 | 2014-09-16 |
| 1437401130 | Jennifer K Popp | Specialist/Technologist | 800 W Stadium Ave, West Lafayette, IN 47907 | 2012-10-05 |
| Find all providers in zip 47907 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639561095 | Katherine Pimmler | Student in an Organized Health Care Education/Training Program | 7442 Abby Marle E, West Lafayette, IN 47906-9682 | 2015-02-23 |
| 1780291419 | Madison Taylor Stewart | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-27 |
| 1821564808 | Jaylynn Bean | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2018-10-17 |
| 1912485756 | Morgan Renay Schumacher | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2018-08-03 |
| 1558849398 | Amanda Elaine Krzyzanowski | Student in an Organized Health Care Education/Training Program | 900 John R Wooden Dr, West Lafayette, IN 47906 | 2018-08-03 |
| 1942727185 | Michelle Ann Parr | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2017-08-28 |
| 1760842900 | Emily Rupp | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2016-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204442 | Stephanie Copeland | Student in an Organized Health Care Education/Training Program | 2508 Castor Ln, Madison, IN 47250-2496 | 2020-10-26 |
| 1801493226 | Justin Clark | Student in an Organized Health Care Education/Training Program | 7337 Wythe Dr, Noblesville, IN 46062-7785 | 2020-10-08 |
| 1962009639 | Raegan Michelle Walther | Student in an Organized Health Care Education/Training Program | 8489 W 700 N, Fair Oaks, IN 47943-8527 | 2020-10-06 |
| 1255938197 | Christopher Rodney West | Student in an Organized Health Care Education/Training Program | 8616 Burrell Ln, Indianapolis, IN 46256-6306 | 2020-10-05 |
| 1285241828 | Paris Janee Avant | Student in an Organized Health Care Education/Training Program | 8926 Mario Creek Dr, Indianapolis, IN 46234 | 2020-09-28 |
| 1740897362 | Taylor Traub | Student in an Organized Health Care Education/Training Program | 12890 Old Meridian St Apt 350, Carmel, IN 46032-8934 | 2020-09-28 |
| 1962016931 | Grant Sylvester Olsen | Student in an Organized Health Care Education/Training Program | 3910 Newport Ave Apt 13, Fort Wayne, IN 46805-1383 | 2020-09-07 |
| 1992318158 | Maria Yvette Borden | Student in an Organized Health Care Education/Training Program | University of Indianapolis, Health Pavilion 253, Indianapolis, IN 46217 | 2020-08-27 |
| 1073126504 | Emily Marie Shoupe | Student in an Organized Health Care Education/Training Program | 15342 Monterosa Dr, Granger, IN 46530-9494 | 2020-08-25 |
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
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| City | WEST LAFAYETTE |
| Zip Code | 47907 |
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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.