Individual provider Active NPI

John H. Kinney, M.D.

  • Family Medicine Physician
  • Pomeroy, OH
National Provider Identifier
1013964949
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-04-6689 Issued in OH
Practice address
88 E Memorial Dr
Pomeroy, OH 45769-9569
Phone
(740) 992-0060
Fax
(740) 446-5154
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-04-6689 OH Primary

Addresses

Primary practice location

88 E Memorial Dr
Pomeroy, OH 45769-9569

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 441-1934

Other identifiers 8

IdentifierTypeStateIssuer
0554798MedicaidOH
310917085030OtherOHOH MEDICAID CARESOURCE
0554798OtherOHMOLINA MEDICAID
930058712OtherRR MEDICARE
0048314000MedicaidWV
000000185220OtherUNISON MEDICAID
000000477252OtherANTHEM BCBS
001714101OtherMOUNTAIN STATE BCBS

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Clinic, LLC Current Accepting new patients

Locations

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

88 E Memorial Dr
Pomeroy, OH 45769
Phone (740) 992-0060

Interoperability endpoints

  • Direct secure messaging: john.kinney.1@17433.direct.athenahealth.com

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1013964949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-441-1934",
            "fax_number": "740-446-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E MEMORIAL DR",
            "city": "POMEROY",
            "state": "OH",
            "postal_code": "457699569",
            "telephone_number": "740-992-0060",
            "fax_number": "740-446-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "JOHN",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-04-6689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0554798",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH  MEDICAID CARESOURCE",
            "identifier": "310917085030",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA MEDICAID",
            "identifier": "0554798",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "930058712",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048314000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON MEDICAID",
            "identifier": "000000185220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000477252",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BCBS",
            "identifier": "001714101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomeroy, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.