Ricky L Kidman, PA-C is a medicare enrolled "Physician Assistant - Medical" in Aynor, South Carolina. He went to University Of Nebraska College Of Medicine and graduated in 1994 and has 30 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Conway Hospital Community Services and his current practice location is
51 11th Avenue, Aynor, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(843) 358-3700.
Ricky L Kidman is licensed to practice in South Carolina (license number 1094) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1962466532.
Provider's Profile
| Full Name | Ricky L Kidman |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 30 Years |
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| Location | 51 11th Avenue, Aynor, South Carolina |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ricky L Kidman attended and graduated from University Of Nebraska College Of Medicine in 1994
NPI Data:
- NPI Number: 1962466532
- Provider Enumeration Date: 04/12/2006
- Last Update Date: 12/18/2023
Medicare PECOS Information:
- PECOS PAC ID: 9032117122
- Enrollment ID: I20061128000420
Medical Identifiers
Medical identifiers for Ricky L Kidman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962466532 | NPI | - | NPPES |
| 1140PA | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363AM0700X | Physician Assistant - Medical | 1094 (South Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Conway Hospital Community Services | 9830087774 | 5 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ricky L Kidman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ricky L Kidman, PA-C
300 Singleton Ridge Rd, Attention Pns Credentialing,
Conway, SC 29526-9142
Ph: (843) 234-6946 | Ricky L Kidman, PA-C
51 11th Avenue,
Aynor, SC 29511-3249
Ph: (843) 358-3700 |
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