Individual provider Active NPI

Lynn M Kincanon, N.P.

  • Adult Health Nurse Practitioner
  • Loveland, CO
National Provider Identifier
1356347751
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APN.0003127-NP Issued in CO
Practice address
2500 Rocky Mountain Ave
Unit 100
Loveland, CO 80538-9004
Phone
(970) 624-1800
Fax
(970) 624-1891
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 61296 NE
Nurse Practitioner 363L00000X 3127 CO
Adult Health Nurse Practitioner 363LA2200X APN.0003127-NP CO Primary
Registered Nurse 163W00000X RN.0124407 CO

Addresses

Primary practice location

2500 Rocky Mountain Ave
Unit 100
Loveland, CO 80538-9004

Mailing address

2500 Rocky Mountain Ave
Suite 100
Loveland, CO 80538-9004
Phone (970) 624-1800

Other identifiers 1

IdentifierTypeStateIssuer
37309072MedicaidCO

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.0124407COMDRegistered Nurse
3127COMDOccupational Therapist
APN.0003127-NPCOMDAdult Health Nurse Practitioner
61296NEMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1356347751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1800",
            "fax_number": "970-624-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROCKY MOUNTAIN AVE",
            "address_2": "UNIT 100",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389004",
            "telephone_number": "970-624-1800",
            "fax_number": "970-624-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCANON",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "61296",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "3127",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "APN.0003127-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.0124407",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37309072",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.