Individual provider Active NPI

Thomas McKinney, MD

  • Pediatrics Physician
  • Chesterfield, MO
National Provider Identifier
1073623641
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R6C76 Issued in MO
Practice address
226 S Woods Mill Rd Ste 32W
Chesterfield, MO 63017-3442
Phone
(314) 576-1616
Fax
(314) 576-5271
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R6C76 MO Primary

Addresses

Primary practice location

226 S Woods Mill Rd Ste 32W
Chesterfield, MO 63017-3442

Mailing address

226 S Woods Mill Rd Ste 32W
Chesterfield, MO 63017-3442
Phone (314) 576-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20241227000624 MO Practitioner - Pediatric Medicine 8022545300 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R6C76MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinia Healthcare Current Accepting new patients
Affinia Healthcare CurrentSince Oct 21, 2024 Accepting new patients
Affinia Healthcare CurrentSince Oct 21, 2024 Accepting new patients
SSM Health Care St. Louis Pediatrics Past Accepting new patients
St Louis Pediatric Associates, Inc Pediatrics Past Accepting new patients
Affinia Healthcare Past Accepting new patients

Locations

1717 Biddle St
Saint Louis, MO 63106
Phone (314) 814-8515

2220 Lemp Ave
Saint Louis, MO 63104
Phone (314) 814-8531

Organizations & group practices 6

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073623641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 32W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173442",
            "telephone_number": "314-576-1616",
            "fax_number": "314-576-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 32W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173442",
            "telephone_number": "314-576-1616",
            "fax_number": "314-576-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R6C76",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.