Individual provider Active NPI

Leah Jane McKinnon, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Albuquerque, NM
National Provider Identifier
1023051513
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
87-117 Issued in NM
Practice address
502 Elm St NE
Albuquerque, NM 87102-2512
Phone
(505) 841-1000
Fax
(505) 843-2592
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 21311 OK
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 87-117 NM Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X A52104 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X K8795 TX
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X C-6860 AR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 35.086978 OH

Addresses

Primary practice location

502 Elm St NE
Albuquerque, NM 87102-2512

Mailing address

502 Elm St NE
Albuquerque, NM 87102-2512
Phone (505) 841-1000

Other identifiers 1

IdentifierTypeStateIssuer
10077340AMedicaidOK

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

State licenses

LicenseStateTypeSpecialty
C-6860ARMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
A52104CAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
87-117NMMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35.086978OHMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
21311OKMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Healthcare Services Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Soaak Clinics LLC PastSince Jul 21, 2024 Accepting new patients

Organizations & group practices 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1023051513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-841-1000",
            "fax_number": "505-843-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-841-1000",
            "fax_number": "505-843-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "LEAH",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OK",
            "license": "21311",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NM",
            "license": "87-117",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A52104",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "K8795",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AR",
            "license": "C-6860",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35.086978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10077340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.