Active NPI
Kwanza Lincoln
- Physician Assistant
- JB Andrews, MD
National Provider Identifier
1134644750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1060 W Perimeter Rd
JB Andrews, MD 20762-6602 - Phone
- (240) 857-8937
- NPI assigned
- Aug 4, 2017
- Last updated
- Aug 31, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary | |
| Military Health Care Provider | 171000000X | NU |
Addresses
Primary practice location
1060 W Perimeter Rd
JB Andrews, MD 20762-6602
Mailing address
204 W Hill Blvd
Charleston, SC 29404-4704
Other practice location 1
204 W Hill Blvd
Charleston, SC 29404-4704
Phone (843) 963-6799
Other practice location 2
3520 Zemke Ave
Tampa, FL 33621
Phone (813) 827-9263
Other practice location 3
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Phone (240) 612-1250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190626003293 | FL | Order and Referring Only - Physician Assistant | 7911231816 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1134644750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 W HILL BLVD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294044704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 W PERIMETER RD",
"city": "JB ANDREWS",
"state": "MD",
"postal_code": "207626602",
"telephone_number": "240-857-8937"
}
],
"practiceLocations": [
{
"address_1": "204 W Hill Blvd",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294044704",
"country_code": "US",
"telephone_number": "843-963-6799",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3520 Zemke Ave",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "33621",
"country_code": "US",
"telephone_number": "813-827-9263",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2501 Capehart Rd",
"address_purpose": "LOCATION",
"city": "Offutt AFB",
"state": "NE",
"postal_code": "681131043",
"country_code": "US",
"telephone_number": "240-612-1250",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LINCOLN",
"first_name": "KWANZA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-04",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in JB Andrews, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.