Organization Active NPI

Kinkaid Medical Group Inc.

  • Physical Medicine & Rehabilitation Physician
  • Stafford, TX
National Provider Identifier
1306725841
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
KINKAID MEDICAL GROUP INC.
Practice address
3727 Greenbriar Dr Ste 118
Stafford, TX 77477-3929
Phone
(346) 874-7874
NPI assigned
Aug 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Authorized official

Name
Yemi Adesola
Title
Director
Phone
(346) 874-7874

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

3727 Greenbriar Dr Ste 118
Stafford, TX 77477-3929

Mailing address

PO Box 642
Stafford, TX 77497-0642

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1306725841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774970642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 GREENBRIAR DR STE 118",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773929",
            "telephone_number": "346-874-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINKAID MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "ADESOLA",
        "authorized_official_first_name": "YEMI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "346-874-7874"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.