Individual provider Active NPI

Cindy Lou Kacinko, ARNP

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1972743581
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1197502 Issued in FL
Practice address
10150 Highland Manor Dr Ste 240
Tampa, FL 33610
Phone
(813) 259-1013
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1197502 FL Primary

Addresses

Primary practice location

10150 Highland Manor Dr Ste 240
Tampa, FL 33610

Mailing address

270 Main St N Ste 300
Stillwater, MN 55082-6788

Other practice location 1

300 S Hyde Park Ave
ste. 210
Tampa, FL 33606-4125
Phone (813) 259-1013

Other practice location 2

300 S Hyde Park Ave
ste. 210
Tampa, FL 33606-4125
Phone (813) 259-1013

Other identifiers 1

IdentifierTypeStateIssuer
1972743581OtherFLNPI

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1197502FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors at Home LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1972743581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 MAIN ST N STE 300",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR STE 240",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "813-259-1013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S Hyde Park Ave",
            "address_2": "ste. 210",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336064125",
            "country_code": "US",
            "telephone_number": "813-259-1013",
            "fax_number": "813-254-0396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 S Hyde Park Ave",
            "address_2": "ste. 210",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336064125",
            "country_code": "US",
            "telephone_number": "813-259-1013",
            "fax_number": "813-254-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACINKO",
        "first_name": "CINDY",
        "middle_name": "LOU",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "1197502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972743581",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.