Individual provider Active NPI

Amy Rochelle Kinkade, OTR/L

  • Occupational Therapist
  • Yuma, AZ
National Provider Identifier
1255527230
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3703 Issued in AZ
Practice address
901 W 24TH St
Yuma, AZ 85364-6384
Phone
(928) 726-5000
NPI assigned
Sep 24, 2007
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3703 AZ Primary

Addresses

Primary practice location

901 W 24TH St
Yuma, AZ 85364-6384

Mailing address

2150 E 25TH PL
Yuma, AZ 85365-3243
Phone (928) 271-9927

Other identifiers 2

IdentifierTypeStateIssuer
1055052OtherNATIONAL
3703OtherAZSTATE

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis Health Group LLCGroup PAC ID 4284022203, 16 clinicians

Practice addresses (Care Compare)

10034 W 151St St
Overland Park, KS 66221-9326
Phone (816) 809-1085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3703AZMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Hospital, LLC Current Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/doct-48e85447

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.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1255527230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 E 25TH PL",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853653243",
            "telephone_number": "928-271-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646384",
            "telephone_number": "928-726-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINKADE",
        "first_name": "AMY",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL",
            "identifier": "1055052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "3703",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.