Individual provider Active NPI

Troy Kubincanek, RN

  • Registered Nurse
  • Medina, OH
National Provider Identifier
1053070581
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.347868 Issued in OH
Practice address
246 Northland Dr
Medina, OH 44256-3441
Phone
(440) 260-8300
NPI assigned
Dec 13, 2021
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.347868 OH Primary

Addresses

Primary practice location

246 Northland Dr
Medina, OH 44256-3441

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Other practice location 1

3094 W Market St Ste 105
Fairlawn, OH 44333-3617
Phone (440) 260-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.347868OHMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1053070581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563441",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3094 W Market St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443333617",
            "country_code": "US",
            "telephone_number": "440-260-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBINCANEK",
        "first_name": "TROY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.347868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.