NPIMap

Individual provider Active NPI

Carmen Kincaid, NP

  • Gerontology Nurse Practitioner
  • Flint, MI
National Provider Identifier
1982156972
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704287572 Issued in MI
Practice address
4444 W Bristol Rd Ste 150
Flint, MI 48507-3161
Phone
(248) 434-6169
Fax
(855) 618-6655
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704287572 MI Primary

Addresses

Primary practice location

4444 W Bristol Rd Ste 150
Flint, MI 48507-3161

Mailing address

4444 W Bristol Rd Ste 150
Flint, MI 48507-3161
Phone (248) 434-6169

Other practice location 1

1409 S Graham Rd
Flint, MI 48532-3538
Phone (810) 235-2599

Other names 1

  • Carmen Jordan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220310002154 MI Practitioner - Nurse Practitioner 3971998865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Okemos, MI 48864
Phone (517) 347-4085

4444 W Bristol Rd
Suite 330
Flint, MI 48507-3159
Phone (810) 230-9500

Hospital & facility affiliations

  • Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
  • Alpine Care Home Health Home health agency, Troy, MI, CCN 237510
  • McLaren Home Health Home health agency, Davison, MI, CCN 237010
  • Centerwell Home Health Home health agency, Flint, MI, CCN 237136
  • The Care Team Home health agency, Saginaw, MI, CCN 239226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704287572MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Oct 1, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Oct 1, 2023 Accepting new patients

Locations

4444 W Bristol Rd
Ste 150
Flint, MI 48507
Phone (810) 230-9500

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

2205 Jolly Rd
Ste A
Okemos, MI 48864
Phone (517) 347-4085

Interoperability endpoints

  • Direct secure messaging: carmen.kincaid.1@32913.direct.athenahealth.com

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1982156972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W BRISTOL RD STE 150",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073161",
            "telephone_number": "248-434-6169",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W BRISTOL RD STE 150",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073161",
            "telephone_number": "248-434-6169",
            "fax_number": "855-618-6655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 S Graham Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323538",
            "country_code": "US",
            "telephone_number": "810-235-2599",
            "fax_number": "810-235-2536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "CARMEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704287572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "JORDAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.