MEDICARE: DR. AUTUMN CASSIDY KIDD PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	30902	MD

General Provider Information

NPI Number	:	1063346153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUTUMN CASSIDY KIDD PT, DPT

Provider Business Mailing Address
First Line	:	7235 PERFECT DAY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7123
Country	:	US
Telephone Number	:	702-756-2279
Fax Number	:

Provider Business Practice Location Address
First Line	:	10753 FALLS RD
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-4535
Country	:	US
Telephone Number	:	410-583-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

Similar Medicare Providers

1821039108 — CARL JOHNSON M.D.
Practice Location Address:

10753 FALLS RD
LUTHERVILLE TIMONIUM, MD
21093-4535

Practice Phone: 410-583-2727
Practice Fax:

1104049063 — MS. ALLEGRA JACQUELINE HAMMAN CRNP
Practice Location Address:

10753 FALLS RD , JOHNS HOPKINS AT GREEN SPRING SUITE 315
LUTHERVILLE TIMONIUM, MD
21093-4535

Practice Phone: 410-583-2926
Practice Fax: 410-583-2883

1508014481 — DR. HEATHER FELL SATEIA MD
Practice Location Address:

10753 FALLS RD , PAVILION II, SUITE 325
LUTHERVILLE TIMONIUM, MD
21093-4535

Practice Phone: 410-583-2774
Practice Fax:

1760777809 — DR. YOUNGJEE CHOI MD
Practice Location Address:

10753 FALLS RD , SUITE 325
LUTHERVILLE TIMONIUM, MD
21093-4535

Practice Phone: 410-583-2774
Practice Fax: 410-583-2883

1598758930 — MR. GARY HORSMON PA-C, ATC
Practice Location Address:

10753 FALLS RD , SUITE 215
LUTHERVILLE, MD
21093-4535

Practice Phone: 410-583-2850
Practice Fax:

1710962378 — MELVIN MILES FRIEDMAN M.D.
Practice Location Address:

10753 FALLS RD , 215
LUTHERVILLE, MD
21093-4535

Practice Phone: 410-583-2858
Practice Fax: 410-583-2544

Directions to “ DR. AUTUMN CASSIDY KIDD PT, DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.