Individual provider Active NPI

Rebecca Catherine Kincaid

  • Student in an Organized Health Care Education/Training Program
  • Mount Olive, WV
National Provider Identifier
1104709401
Registry record updated Jul 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1 Mountain Side Way
Mount Olive, WV 25185-0001
Phone
(721) 330-4442
NPI assigned
Jul 26, 2025
Last updated
Jul 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WV Primary

Addresses

Primary practice location

1 Mountain Side Way
Mount Olive, WV 25185-0001

Mailing address

531 Carter Dr
Charleston, WV 25306-6288
Phone (304) 932-6282

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

NPI Registry JSON

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

{
    "created_epoch": "1753488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753488000000",
    "number": "1104709401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 CARTER DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253066288",
            "telephone_number": "304-932-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MOUNTAIN SIDE WAY",
            "city": "MOUNT OLIVE",
            "state": "WV",
            "postal_code": "251850001",
            "telephone_number": "721-330-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "REBECCA",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-26",
        "last_updated": "2025-07-26",
        "certification_date": "2025-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Olive, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2025; 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.