LAURA R KIDD (P.A.) – Physician Assistant, NPI 1396842480

LAURA R KIDD (P.A.) is a healthcare provider. based in West frankfort, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 085.002750 (IL). The NPI Number for LAURA R KIDD (P.A.) is 1396842480

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
LAURA R KIDD (P.A.)
NPI
1396842480
Phone
(618) 932-3937
Address
2553 Ken Gray Blvd
Enumeration Date
20 September 2006
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6189373400
Graduation Year
2003 (23 years ago)
PAC ID
3476550385
Group Practice PAC ID
3678677390
Professional Enrollment ID
I20080923000275
Address ID
IL628961968WE502XXSTXX501

Contacts

Secure Messaging
laurakidd@siusm.allscriptsdirect.net
Secure Messaging
lkidd16006@sih.direct-ci.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for LAURA R KIDD (P.A.)

  • 2553 Ken Gray Blvd

    West Frankfort, IL 628964174

    Phone: (618) 932-3937

    Fax: (618) 932-2734

    Type: Location

  • 200, West Jackson Street, Carbondale, Jackson County, Illinois, 62901, United States

    CARBONDALE, IL 629011474

    Phone: (618) 536-6621

    Fax: (618) 453-1102

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $213.

Total Amount is formed as General ($213) + Research ($0) + Ownership ($0) = $213.

Last reported payment date: 2024-08-26 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($145).

Total Amount

$213

General + Research + Ownership

Payments

5

Total payment records

General Amount

$213

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-09-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080923000275IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
81002Urinalysis, manual test1311$0
View full utilization report →

Insurance plans in this area (ZIP 62896)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3678677390View full group profile
NameSpecialtyState
H E M A T O L O G Y/ O N C O L O G YIL
Cardiovascular Disease (Cardiology)IL
-IL
Emergency MedicineIL
Nurse PractitionerMO
Nurse PractitionerIL
Emergency MedicineIL
-IL
N E U R O L O G YIL
U R O L O G YIL

Reviews

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Frequently asked questions

What federal number belongs to LAURA R KIDD (P.A.)?
The federal identifier for LAURA R KIDD (P.A.) is NPI 1396842480.
Does this profile mean LAURA R KIDD (P.A.) is currently active?
Yes — LAURA R KIDD (P.A.) appears active in the national provider directory.
What kind of provider is LAURA R KIDD (P.A.)?
The page reflects Physician Assistant for LAURA R KIDD (P.A.). Clinical services aligned with this taxonomy classification.
What location metadata exists for LAURA R KIDD (P.A.)?
The page summarizes West Frankfort, Illinois for LAURA R KIDD (P.A.); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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