Individual provider Active NPI

Benjamin Tyler McKinney, MD

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1003443292
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
67644 Issued in TN
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 692-1000
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 67644 TN Primary

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

1918 Jamestown Rd
Johnson City, TN 37604-7687
Phone (423) 773-1359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220927003870 SC Practitioner - Emergency Medicine 8022434174 Reassigns benefits to 1 organization
I20230616000269 TN Practitioner - Emergency Medicine 8022434174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians

Practice addresses (Care Compare)

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
  • Sycamore Shoals Hospital Hospital, Elizabethton, TN, CCN 440018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince May 13, 2023 Accepting new patients
Tri-Cities Observation Services, PC Emergency Medicine CurrentSince Aug 13, 2023 Accepting new patients
McLeod Health Cheraw CurrentSince Aug 16, 2022 Accepting new patients
McLeod Health Cheraw Emergency Medicine CurrentSince Aug 16, 2022 Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1003443292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 JAMESTOWN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047687",
            "telephone_number": "423-773-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "BENJAMIN",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "67644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.