Ricky Lee Kidman (NPI# 1962466532, PAC ID# 9032117122) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1962466532 |
| PAC ID by PECOS | 9032117122 |
| Professional Enrollment ID | I20061128000420 |
| Full Name | Ricky Lee Kidman |
| Organization Legal Name | MEDICAL UNIVERSITY HOSPITAL AUTHORITY |
| Address |
511 S Main St Mullins SC 29574-3509 |
| Phone Number | 8434648244 |
| Gender | M |
| Credential | PA |
| Graduation Year | 1994 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1557268950 |
| Number of Group Practice Members | 123 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420055 | CAROLINAS HOSPITAL SYSTEM MARION |
| Address | Phone | Organization |
|---|---|---|
| 1341 Old Georgetown Rd, Suite C, Mount Pleasant, SC 29464-7307 | 8438842175 | CAROLINA FAMILY CARE INC |
| 511 S Main St, Mullins, SC 29574-3509 | 8434648244 | MEDICAL UNIVERSITY HOSPITAL AUTHORITY |
| 511 S Main St, Mullins, SC 29574-3509 | CAROLINA FAMILY CARE INC |
| Organization Legal Name | MEDICAL UNIVERSITY HOSPITAL AUTHORITY |
| Physicians | 135 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julianne Martins Parente Heck | Internal Medicine | Medical University Hospital Authority | 1205 N Main St, Marion, SC 29571-2008 |
| Michele M Ballister | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Christopher A Hensley | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Angela R Mund | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Jeanne M Barreira | Certified Nurse Midwife (cnm) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Ginger L Brister | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Helen E Harman | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Annette Cooper | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Marianna P Ross | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Elizabeth G Hirsch | Certified Registered Nurse Anesthetist (crna) | Medical University Hospital Authority | 171 Ashley Ave, Charleston, SC 29425-8908 |
| Street Address |
511 S MAIN ST |
| City | MULLINS |
| State | SC |
| Zip | 29574-3509 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yola Augustin | Internal Medicine | Ted J Triana Do PC | 511 S Main St, North Syracuse, NY 13212-2813 |
| Gangatharan Mathisuthan | Internal Medicine | Medical University Hospital Authority | 511 S Main St, Mullins, SC 29574-3509 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Iris M Floyd Norris | Family Medicine | Carolina Family Care Inc | 2845 E Hwy 76, Suite 7, Mullins, SC 29574 |
| Daniel Ng | Cardiovascular Disease (cardiology) | Carolina Family Care Inc | 2845 E Hwy 76, Suite 5, Mullins, SC 29574 |
| Frederick J Hamilton | Orthopedic Surgery | Carolina Family Care Inc | 2845 E Hwy 76, Suite 5, Mullins, SC 29574 |
| Chadwick V Thomas | General Surgery | Carolina Family Care Inc | 119 W Lowman St, Mullins, SC 29574-3107 |
| Parakkat Gopalakrishnan | General Surgery | Carolina Family Care Inc | 119 W Lowman St, Mullins, SC 29574-3107 |
| Robert Louis De Grood | General Surgery | Carolina Family Care Inc | 119 W Lowman St, Mullins, SC 29574-3107 |
| Mitchell E Falk | Chiropractic | 270 S Main St, Spine Care Center, Mullins, SC 29574-3120 | |
| Kathy M Thompkins | Nurse Practitioner | 1002 S Main St, Mullins, SC 29574-3920 | |
| Alecia R Anyim | Internal Medicine | App of South Carolina Hm Pllc | 2829 Us, Suite 76, Mullins, SC 29574-6035 |
| George Dawson | Orthopedic Surgery | 2829e Hwy 76, Mullins, SC 29574-6035 | |
| Find all physicians in zip 29574 | |||
| City | MULLINS |
| Zip Code | 29574 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MULLINS + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.