Active NPI
Mitchell Kincaid
- Pharmacist
- Ithaca, NY
National Provider Identifier
1730728189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 064150
- Practice address
- 500 S Meadow St
Ithaca, NY 14850-5317 - Phone
- (607) 277-5750
- NPI assigned
- Jan 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 064150 | NY | Primary |
Addresses
Primary practice location
500 S Meadow St
Ithaca, NY 14850-5317
Mailing address
1062 Dryden Rd Apt 21
Ithaca, NY 14850-8800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064150 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577923200000",
"number": "1730728189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 DRYDEN RD APT 21",
"city": "ITHACA",
"state": "NY",
"postal_code": "148508800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S MEADOW ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505317",
"telephone_number": "607-277-5750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINCAID",
"first_name": "MITCHELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-02",
"last_updated": "2020-01-02",
"certification_date": "2020-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "064150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.