CRYSTAL MCKIDDY (NPI# 1568732618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568732618 |
| Entity Type | Individual |
| Full Name | CRYSTAL MCKIDDY |
| Credential | P.A |
| Practice Address |
19536 Alberta St Oneida TN 37841-3382 |
| Mailing Address |
695 Pleasant Grove Rd Winfield TN 37892-4009 |
| Practice Telephone | 4235693278 |
| Practice Fax Number | 4235694414 |
| Mailing Telephone | 4232152002 |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2020-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 2075 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1887 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 475 N Highway 25 W, Suite 100, Williamsburg, KY 407691576 | 6065492933 | 6065493036 |
| Street Address |
19536 ALBERTA ST |
| City | ONEIDA |
| State | TN |
| Zip Code | 37841-3382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386155059 | Ammie S Webb | Nurse Practitioner | 19536 Alberta St, Oneida, TN 37841-3382 | 2017-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811495161 | Kristin Alexis Henry | Physical Therapist | 530 Industrial Ln, Oneida, TN 37841 | 2018-01-31 |
| 1730504754 | Southern Psychiatric Services | Psychiatry & Neurology | 216 North Cross Street, Oneida, TN 37841 | 2014-02-27 |
| 1700142619 | Stephen Daniel Cross | Pharmacist | 20029 Alberta St., Oneida, TN 37841 | 2012-04-04 |
| 1730342700 | Ava Lynn Adcock | Speech-Language Pathologist | 127 Cross Street, Oneida, TN 37841 | 2008-07-09 |
| 1922289560 | Scott County Surgical Associates P.a. | Surgery | 615 N. Main Street, Oneida, TN 37841 | 2007-11-26 |
| 1205035185 | James Wyatt Denzler | Pharmacist | 19856 Alberta St, Oneida, TN 37841 | 2007-07-12 |
| 1073735569 | Dennis K Baird | Dentist | 204 South Bank Street, Oneida, TN 37841 | 2007-05-03 |
| 1629103635 | J. Gregory Roberts Md Rvt | Specialist | 223 Andrew Dr, Oneida, TN 37841 | 2007-02-22 |
| 1790840767 | Synergistics, Inc. | Occupational Therapy Assistant | 125 Cross Street, Oneida, TN 37841 | 2006-12-27 |
| 1033282405 | Scott County Medical Clinic Inc | Clinic/Center | 19268 Alberta Ave, Oneida, TN 37841 | 2006-11-15 |
| Find all providers in zip 37841 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528541018 | Joseph Charles Lumia | Physician Assistant | 600 Seneca St Ste 4, Oneida, NY 13421-2743 | 2018-09-11 |
| 1326424888 | Jessica Jeong | Physician Assistant | 357 Genesee St Ste 2, Oneida, NY 13421-2658 | 2015-08-07 |
| 1629406137 | Kaitlyn Elizabeth Huysman | Physician Assistant | 600 Seneca St, Oneida, NY 13421-2668 | 2013-10-18 |
| 1659301729 | Timothy Mihm | Physician Assistant | 357 Genesee St, Suite # 2, Oneida, NY 13421-2658 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840972 | Alexis Sierra Foster | Physician Assistant | 953 Prince Ave, Erwin, TN 37650-1445 | 2020-11-01 |
| 1972110831 | Marleen Yosef | Physician Assistant | 6 Whitsett Rd, Nashville, TN 37210-5345 | 2020-09-24 |
| 1538772744 | Kaitlyn Blair Barger | Physician Assistant | 2100 Clinch Ave Ste 120, Knoxville, TN 37916-2288 | 2020-08-26 |
| 1225653967 | Molly Ann Waggoner | Physician Assistant | 9050 Executive Park Dr Ste 100b, Knoxville, TN 37923-4616 | 2020-06-09 |
| 1134749922 | Mckenzie Jacobson | Physician Assistant | 302 Tyson Ave # B, Paris, TN 38242-4576 | 2020-04-21 |
| 1316580913 | Donald Jacob Calella | Physician Assistant | 8146 Propeller Dr, Ooltewah, TN 37363-9561 | 2019-10-26 |
| 1811458565 | Physician Associate Resources, Plc | Physician Assistant | 1559 Highland Park Drive, Lenoir City, TN 37772 | 2019-03-26 |
| 1336617059 | Micaela L Goebel | Physician Assistant | 120 Tanner Pl Bldg H, Clinton, TN 37716-6684 | 2018-11-12 |
| 1700369162 | Lauren Peyton Hunley | Physician Assistant | 6890 W Andrew Johnson Hwy, Talbott, TN 37877-8610 | 2018-09-12 |
| 1275039471 | Jessica Taylor Epting | Physician Assistant | 107 Glen Oak Blvd Ste 200, Hendersonville, TN 37075-3162 | 2018-04-05 |
| Find all providers with the same taxonomy | ||||
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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.