Active NPI
John Gordon Kincaid, PT
- Physical Therapist
- Renton, WA
National Provider Identifier
1780888149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00005783
- Practice address
- 3600 Lind Avenue SW
Suite 170
Renton, WA 98057 - Phone
- (425) 656-5020
- Fax
- (425) 656-4218
- NPI assigned
- Jun 12, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00005783 | WA | Primary |
Addresses
Primary practice location
3600 Lind Avenue SW
Suite 170
Renton, WA 98057
Mailing address
17915 112TH Ave SE
Renton, WA 98055
Phone (425) 204-8519
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780888149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17915 112TH AVE SE",
"city": "RENTON",
"state": "WA",
"postal_code": "98055",
"telephone_number": "425-204-8519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 LIND AVENUE SW",
"address_2": "SUITE 170",
"city": "RENTON",
"state": "WA",
"postal_code": "98057",
"telephone_number": "425-656-5020",
"fax_number": "425-656-4218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINCAID",
"first_name": "JOHN",
"middle_name": "GORDON",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "00005783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.