Jeb Kincannon, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Practice address

6500 Crill Ave BLDG 3
Palatka, FL 32177-9231

Phone

(386) 325-1119

NPI assigned

Nov 20, 2023

Last updated

Nov 20, 2023By the provider in NPPES

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 FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concierge Physio LLCGroup PAC ID 4082047667, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Concierge Physio LLC

  dba Direct Orthopedic Therapy

  • Physical Therapist
  • Jacksonville Beach, FL
  • NPI 1013559632

  Orthopedic

  Medicare reassignment Care Compare group NPD
• Revision Health Services, PLLC

  • Physical Therapy Clinic/Center
  • Ponte Vedra, FL
  • NPI 1659994911
  Medicare reassignment NPD
• H2 Rehabilitation Services of Florida LLC

  dba H2 Health

  • Rehabilitation Clinic/Center
  • Palatka, FL
  • NPI 1861591158
  NPD (past)

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1831964980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1473",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320851473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE BLDG 3",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779231",
            "telephone_number": "386-325-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCANNON",
        "first_name": "JEB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Kennedy, RPT
• Kepler Enterprises, LLC (BodyMax Physical Therapy)
• Casey R Key, MA, CCC-SLP
• Kids Care Pediatrics,PA
• Kids Care Pediatrics,PA (Kids Care Pediatrics Rural Health Clinic)
• Angela Nicole King, LMT
• Gail King, PHARM D, MBA
• Sarabeth Kirkland, SLPD, CCC-SLP
• Kiva of Palatka
• Kiva of Palatka, LLC

• Orthopedic Physical Therapist in Palatka, FL
• Providers in Palatka, FL by specialty
• Orthopedic Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.