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KIDMED PLLC
NPI 1306684642
Physician Assistant in Cedar Point, NC

Active since July 19, 2024CLIA 34D2310135 · Waiver
1165 CEDAR POINT BLVD STE F, CEDAR POINT, NC 28584(252) 364-4690(252) 606-4325 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2025, Oct 8, 2024, Jul 19, 2024 (3 updates tracked since 2024).

About Kidmed Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIDMED PLLC (NPI 1306684642) is a healthcare organization registered as a physician assistant in Cedar Point, North Carolina and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through August 26, 2026 and lists Kelly Rae Durham, President, as its authorized official.

NPPES Registry Identity

NPI1306684642
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameKIDMED PLLC
Location Address1165 CEDAR POINT BLVD STE FCedar Point, NC 28584-1030
Mailing Address228 E Ivybridge DrHubert, NC 28539-5401 · (910) 340-1521 · Fax (252) 606-4325
Phone(252) 364-4690
Fax(252) 606-4325
Organization SubpartNo
Authorized OfficialKelly Rae DurhamPresident · (910) 340-1521
Enumeration DateJuly 19, 2024
Last NPPES UpdateNovember 19, 20253 updates tracked since enumeration
NPPES CertifiedNovember 19, 2025
✔ NPI 1306684642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1165 CEDAR POINT BLVD STE F, Cedar Point, NC 28584
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2310135

Kidmed PLLC · Cedar Point, NC
Active · expires Aug 26, 2026
CLIA Number34D2310135
Laboratory TypePhysician Office
Certificate Effective DateAugust 27, 2024
Certificate Expiration DateAugust 26, 2026
Laboratory DirectorKelly R. Durham
Laboratory Phone(910) 340-1521
Laboratory LocationKidmed PLLC1165 Cedar Point Boulevard Suite F, Cedar Point, NC 28584
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KELLY RAE DURHAM PA C
Physician Assistant
1165 CEDAR POINT BLVD STE F
CEDAR POINT, NC 28584
Onslow County (252) 364-4690
ANGELA LEE SMITH
Nurse Practitioner
1165 CEDAR POINT BLVD STE F
CEDAR POINT, NC 28584
Onslow County (252) 364-4690

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kidmed PLLC's NPI number?

The NPI number for Kidmed PLLC is 1306684642. It was assigned to this organization in the NPPES registry on July 19, 2024.

Where is Kidmed PLLC located?

Kidmed PLLC is located at 1165 Cedar Point Blvd Ste F, Cedar Point, NC 28584. The listed phone number is (252) 364-4690.

What is Kidmed PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Does Kidmed PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2310135) is associated with this NPI, valid through August 26, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kidmed PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list Kidmed PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kidmed PLLC was last updated on November 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.