Kenneth Mark McIntyre, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101231072 Issued in VA

Practice address

1725 W Monroe St
Wytheville, VA 24382

Phone

(276) 613-3978

Fax

(276) 228-2995

NPI assigned

Aug 11, 2006

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmcintyre96551@direct.carilionclinic.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carilion Emergency Services, Inc.

  dba VelocityCare

  • Urgent Care Clinic/Center
  • Christiansburg, VA
  • NPI 1598533879
  NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1033120308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W MONROE ST",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821655",
            "telephone_number": "276-613-3978",
            "fax_number": "276-228-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W MONROE ST",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "24382",
            "telephone_number": "276-613-3978",
            "fax_number": "276-228-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "KENNETH",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101231072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5859654",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcintyre96551@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kmcintyre96551@direct.carilionclinic.org",
            "address_1": "1725 W Monroe St",
            "city": "Wytheville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "24382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dianne M McCarty, LCSW
• Grayson Pate McCarty, OTR/L
• James Joseph McConnell, MD
• Amy D McGlothin, CERTIFIED OCCUPATION
• Sabrina McGonigal
• Sanjay Rasik Mehta, DO
• Beth Ann Meyer, MSW, LCSW
• Mikes Best Practices Pharmacy LLC (Mike's Best Practices Pharmacy)
• Etthan Charles Miller
• Karen Moore Miller

• Internal Medicine Physician in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.