Individual provider Active NPI

Richard A. Kincaid, APRN-C

  • Family Nurse Practitioner
  • Lebanon, TN
National Provider Identifier
1073742250
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14244 Issued in TN
Practice address
1407 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone
(615) 444-6203
Fax
(615) 444-6252
NPI assigned
Jul 8, 2009
Last updated
Aug 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14244 TN Primary

Addresses

Primary practice location

1407 W Baddour Pkwy
Lebanon, TN 37087-2513

Mailing address

1407 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone (615) 444-6203

Other identifiers 6

IdentifierTypeStateIssuer
3323087OtherTNUHC
4298126OtherTNBCBS
12242154OtherTNCAQH
8302071OtherTNCIGNA
APN0000014244OtherTNAPN LICENSE
RN0000155145OtherTNRN LICENSE (MULTISTATE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110711000201 TN Practitioner - Nurse Practitioner 1052599305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical PCGroup PAC ID 4486544970, 13 clinicians

Practice addresses (Care Compare)

1407 Baddour Pkwy
Lebanon, TN 37087-2513

1407 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone (615) 444-6203

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14244TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical PC CurrentSince Jun 5, 2011 Accepting new patients
Family Medical Community Healthcare, PLLC PastSince Oct 5, 2025 Accepting new patients

Locations

1407 W Baddour Pkwy
Lebanon, TN 37087
Phone (615) 444-6203

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13762/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.161012

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1073742250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "615-444-6203",
            "fax_number": "615-444-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "615-444-6203",
            "fax_number": "615-444-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "RICHARD",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "14244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "3323087",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4298126",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12242154",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8302071",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "APN0000014244",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE (MULTISTATE)",
            "identifier": "RN0000155145",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.