Individual provider Active NPI

Kaitlin Elizabeth Kinkoph, CNM

  • Advanced Practice Midwife
  • Leesburg, VA
National Provider Identifier
1417625401
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024181006 Issued in VA
Practice address
19455 Deerfield Avenue
Suite 204
Leesburg, VA 20176-8102
Phone
(703) 858-1500
Fax
(703) 858-5022
NPI assigned
Sep 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 0024181006 VA Primary

Addresses

Primary practice location

19455 Deerfield Avenue
Suite 204
Leesburg, VA 20176-8102

Mailing address

19455 Deerfield Ave
Leesburg, VA 20176-8100

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
Certified Nurse Midwife

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1417625401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19455 DEERFIELD AVE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19455 DEERFIELD AVENUE",
            "address_2": "SUITE 204",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768102",
            "telephone_number": "703-858-1500",
            "fax_number": "703-858-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINKOPH",
        "first_name": "KAITLIN",
        "middle_name": "ELIZABETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024181006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.