Kinship Pace of Indiana LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

KINSHIP PACE OF INDIANA LLC

Practice address

3734 S Reed Rd
Kokomo, IN 46902-3829

Phone

(570) 371-7371

NPI assigned

Nov 14, 2024

Last updated

Feb 10, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

CITIPACE HOLDING COMPANYAs reported in NPPES

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

Authorized official

Name

Judy Kohn

Title

Interim Ceo, Chief Strategy Officer

Phone

(917) 270-0599

Specialties & licenses 1

Addresses

Other names 1

• Kinship PACE of Indiana - Kokomo Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Kinship Pace of Indiana - Jeffersonville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kinship Pace of Indiana LLC

  • PACE Provider Organization
  • Jeffersonville, IN
  • NPI 1942015813
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather M Mickey, AU.D.

  • Audiologist
  • Indianapolis, IN
  • NPI 1194927038
  NPD (past)

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1538983622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 3RD AVE FL 29",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 S REED RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023829",
            "telephone_number": "570-371-7371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1453 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471304204",
            "country_code": "US",
            "telephone_number": "570-371-7371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINSHIP PACE OF INDIANA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITIPACE HOLDING COMPANY",
        "enumeration_date": "2024-11-14",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "INTERIM CEO, CHIEF STRATEGY OFFICER",
        "authorized_official_telephone_number": "917-270-0599"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinship PACE of Indiana - Kokomo",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa E King, ACNP-BC
• Tracy King
• Faith Ann Kingery, LMFT
• Kurt E. Kingseed, D.D.S.
• Martha Kinney, NP
• Tasha Kirby, RBT, BS
• Angela Dawn Kirkendall, NP
• Doris Kirkpatrick, M.A.
• Kayla B Kirtley
• David Kirubakaran

• PACE Provider Organization in Kokomo, IN
• Providers in Kokomo, IN by specialty
• PACE Provider Organization in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.