Rex A. Incledon, PA-C, CCP

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03561 Issued in TX

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 916-0819

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1114918414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 KARAT DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782325607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INCLEDON",
        "first_name": "REX",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "PA-C, CCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Andrew Husk
• Emily Rebekah Hussing, DPT
• Amanda Caroline Hutchison
• Jade Hwang
• Creighton Ikeda
• Fiona M. Inglis, CRNA
• Brandie L Ingram, FNP-BC
• Alice Inman, PSYD
• Catarina Inoue, MD
• John Inzinna, PTA

• Physician Assistant in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.