Active NPI
John H. Kinney, M.D.
- Family Medicine Physician
- Pomeroy, OH
National Provider Identifier
1013964949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35-04-6689
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0554798 | Medicaid | OH | |
| 310917085030 | Other | OH | OH MEDICAID CARESOURCE |
| 0554798 | Other | OH | MOLINA MEDICAID |
| 930058712 | Other | RR MEDICARE | |
| 0048314000 | Medicaid | WV | |
| 000000185220 | Other | UNISON MEDICAID | |
| 000000477252 | Other | ANTHEM BCBS | |
| 001714101 | Other | MOUNTAIN 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
| Organization | Specialty | Status | New 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
- 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.
-
- Multi-Specialty Clinic/Center
- Gallipolis, OH
- NPI 1508817248
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.