Active NPI
David Kinback, M.S.
- Rehabilitation Counselor
- Ada, OK
National Provider Identifier
1891251328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- License
- 00360622
- Practice address
- 1400 Hoppe Blvd., Suite 3
CN Recovery Resource Services
Ada, OK 74820 - Phone
- (580) 436-1222
- Fax
- (580) 436-1333
- NPI assigned
- Feb 20, 2019
- Last updated
- Feb 20, 2019
- 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 |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | 00360622 | OK | Primary |
Addresses
Primary practice location
1400 Hoppe Blvd., Suite 3
CN Recovery Resource Services
Ada, OK 74820
Mailing address
1300 Hoppe Blvd., Suite 1
CN Resource Management
Ada, OK 74820
Phone (580) 436-7211
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00360622 | OK | MD | Rehabilitation Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chickasaw Nation - Family Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Ada, OK
- NPI 1588968275
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1891251328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 HOPPE BLVD., SUITE 1",
"address_2": "CN RESOURCE MANAGEMENT",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-436-7211",
"fax_number": "580-272-5757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 HOPPE BLVD., SUITE 3",
"address_2": "CN RECOVERY RESOURCE SERVICES",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-436-1222",
"fax_number": "580-436-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINBACK",
"first_name": "DAVID",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-20",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "OK",
"license": "00360622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.