Kourtney Kincaid

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

17-03802 Issued in KS

Practice address

1102 Saint Marys Rd
Junction City, KS 66441-4139

Phone

(785) 762-3350

Fax

(785) 762-3920

NPI assigned

Oct 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Nebraska College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revive Integrative Health LLCGroup PAC ID 1456729193, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Revive Integrative Health LLC.

  • Physical Therapy Clinic/Center
  • Salina, KS
  • NPI 1184387235

  KS, Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1568060069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 W 12TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668016202",
            "telephone_number": "620-208-7878",
            "fax_number": "620-208-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SAINT MARYS RD",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664414139",
            "telephone_number": "785-762-3350",
            "fax_number": "785-762-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "KOURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-03802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harley Kennedy
• Pablo Andres Kennedy, MD
• Vanessa Alexis Key, T-LMSW
• Anwar K Khoury, MD
• Stephanie Michelle Kimbrel, APRN
• Neil Kinsey
• Kalie May Kipp, RDN
• Krystal Bowman Kirk
• Connor Klamert
• John P Kollhoff, PHARM.D.

• All providers in Junction City, KS
• Occupational Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.