Individual provider Active NPI

Autumn Rene Kincaid, CNP

  • Family Nurse Practitioner
  • Lancaster, OH
National Provider Identifier
1710735147
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0035497 Issued in OH
Practice address
2405 N Columbus St Ste 280
Lancaster, OH 43130-7946
Phone
(740) 689-4470
NPI assigned
May 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0035497 OH Primary

Addresses

Primary practice location

2405 N Columbus St Ste 280
Lancaster, OH 43130-7946

Mailing address

401 N Ewing St
Lancaster, OH 43130-3371
Phone (740) 687-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240729000905 OH Practitioner - Nurse Practitioner 6800332628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfield Healthcare Professionals IncGroup PAC ID 4789596362, 144 clinicians

Practice addresses (Care Compare)

2405 N Columbus St
Suite 260
Lancaster, OH 43130-8100
Phone (740) 687-8397

Hospital & facility affiliations

  • Caretenders Vna Home health agency, Lancaster, OH, CCN 367137
  • Fairfield Medical Center Hospital, Lancaster, OH, CCN 360072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0035497OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals, Inc. CurrentSince Jun 16, 2024 Accepting new patients
Fairfield Healthcare Professionals Inc CurrentSince Jun 16, 2024 Accepting new patients
Fairfield Healthcare Professionals, Inc. Past Accepting new patients

Locations

2405 N Columbus St
Ste 280
Lancaster, OH 43130
Phone (740) 689-4470

401 N Ewing St
Ofc
Lancaster, OH 43130

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

131 N Ewing St
Ste C
Lancaster, OH 43130
Phone (740) 689-6600

2405 N Columbus St
Ste 260
Lancaster, OH 43130
Phone (740) 654-8623

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1710735147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N EWING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303371",
            "telephone_number": "740-687-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST STE 280",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431307946",
            "telephone_number": "740-689-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "AUTUMN",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0035497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.