Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Laura R Kidd, PA

Individual provider Physician Assistant · NPI 1396842480

Laura R Kidd, PA is a Physician Assistant in Carbondale, Illinois. Graduated from Southern Illinois University School of Medicine in 2003, 23 years ago. Practices with Select Physical Therapy Holdings Inc, a 2,121-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
23
Trained at
Southern Illinois University School of Medicine
Licensed in
IL
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

409 W Oak St
Carbondale, IL 62901-1414
Phone: (618) 529-4455
Fax: (618) 351-1287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 100 Dr Warren Tuttle Dr, Harrisburg, IL 62946-2718 — (618) 529-4455
  • 217 S Park Ave Ste 2, Herrin, IL 62948-3611 — (618) 529-4455
  • 3905 W Ernestine Dr, Marion, IL 62959-5800 — (618) 529-4455

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.002750 (IL)

Record details

NPI number1396842480
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 20, 2006
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Select Physical Therapy Holdings Inc — 2121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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