Sandra L Kincaid, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP-01725 Issued in NM

Practice address

904 Las Lomas Rd NE
Albuquerque, NM 87102

Phone

(505) 924-2650

NPI assigned

Jan 18, 2011

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Total Community Care

  • PACE Provider Organization
  • Albuquerque, NM
  • NPI 1760549398
  NPD (past)

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1831494137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 LAS LOMAS RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022633",
            "telephone_number": "505-924-2650",
            "fax_number": "505-924-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 LAS LOMAS RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87102",
            "telephone_number": "505-924-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-01725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32256868",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Kimbro, LMHC
• Wendy Kimmelman, CNM
• Daniel Glen Kimura
• Eugene E Kimzey, R.N.
• Erin Jane Kincaid, MS, RD, LD
• Kind Mind NM LLC
• Jacobi Kindle
• Kindling Hope Therapy LLC
• Moaz Kineish, MD
• Angie M. King-Nosseir, RD

• Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.