Kristi Kincheloe, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08721 Issued in TX

Practice address

2301 W Michigan Ave
Midland, TX 79701-5829

Phone

(432) 620-1160

Fax

(432) 620-1156

NPI assigned

Oct 25, 2013

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Texas Tech University Health Sciences Center Lubbock

  • Anatomic Pathology Physician
  • Lubbock, TX
  • NPI 1063461358
  Medicare reassignment
• Texas Tech University Health Sciences Center Lubbock

  • Durable Medical Equipment & Medical Supplies
  • Lubbock, TX
  • NPI 1053458026
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Neurology Physician
  • Lubbock, TX
  • NPI 1518916808
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Psychiatry Physician
  • Lubbock, TX
  • NPI 1881643179
  NPD

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1669800892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 W MICHIGAN AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015829",
            "telephone_number": "432-620-1160",
            "fax_number": "432-620-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W MICHIGAN AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797015829",
            "telephone_number": "432-620-1160",
            "fax_number": "432-620-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCHELOE",
        "first_name": "KRISTI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-25",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Joy Kiley
• Anne Hawthorne Killam, M.S.
• Craig Kim, PA-S
• Peter Kim, PA-S
• Tia Kincannon
• Mark King
• Olivia Ruth Kirklin
• Jena Lee Klabunde
• Darla Renee Klatt, RN
• Elayne Marie Klattenhoff, M.S., CCC-SLP

• Physician Assistant in Midland, TX
• Providers in Midland, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.