Kevin Kinkade, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04025 Issued in TX

Practice address

7777 Forest LN
Dallas, TX 75230-2505

Phone

(972) 566-5667

Fax

(972) 566-4703

NPI assigned

Feb 2, 2007

Sex

Male

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 OK

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

State licenses

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.

• Mercy Hospital Kingfisher, Inc

  • Critical Access Hospital
  • Kingfisher, OK
  • NPI 1083048417
  Medicare reassignment NPD
• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818
  Medicare reassignment NPD
• Mercy Hospital Tishomingo, Inc.

  dba Mercy Hospital Tishomingo

  • Critical Access Hospital
  • Tishomingo, OK
  • NPI 1932404431
  Medicare reassignment NPD
• Mercy Hospital Watonga Inc

  dba Mercy Hospital Watonga

  • Critical Access Hospital
  • Watonga, OK
  • NPI 1497017529
  Medicare reassignment NPD
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Mercy Hospital Kingfisher, Inc

  • Diagnostic Radiology Physician
  • Kingfisher, OK
  • NPI 1285064618
  NPD
• Mercy Hospital Logan County, Inc

  dba Mercy Hospital Logan County Crescent Primary Care

  • Rural Health Clinic/Center
  • Crescent, OK
  • NPI 1659652071
  NPD
• Mercy Hospital Tishomingo, Inc.

  dba Mercy Hospital Tishomingo Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Tishomingo, OK
  • NPI 1578868121
  NPD
• Mercy Hospital El Reno, Inc

  • Emergency Medicine Physician
  • El Reno, OK
  • NPI 1083910442
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679611636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201606",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753201606",
            "telephone_number": "972-758-3598",
            "fax_number": "972-599-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302505",
            "telephone_number": "972-566-5667",
            "fax_number": "972-566-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINKADE",
        "first_name": "KEVIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kingsley Optical Inc
• Joanna Kingsley Tavarez, MD
• Kingsman Consulting LLC
• Kingston Emergency Physicians Medical Group PLLC
• Adean Audace Kingston, MD
• Ashton Nicole Kinkead, PA-C
• Kari Cristine Kinkead, CRNA
• Nedha Kinnare, MD
• Jennifer Kinnear, D.C.
• Lisa E Kinnear, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.