Active NPI
Christina McKinley
- Adult Medicine Physician
- Covington, LA
National Provider Identifier
1083376594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- Legal business name
- CHRISTINA MCKINLEY
- Practice address
- 71107 Highway 21
Covington, LA 70433-7243 - Phone
- (985) 781-0548
- Fax
- (985) 781-4319
- NPI assigned
- Oct 12, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christina M McKinley, MD
- Title
- Owner
- Phone
- (504) 232-5695
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | Primary |
Addresses
Primary practice location
71107 Highway 21
Covington, LA 70433-7243
Mailing address
211 Churchill Downs Dr
Bush, LA 70431-4504
Phone (504) 232-5695
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211123003058 | LA | Part B Supplier - Clinic/Group Practice | 5294125704 |
Receives reassigned benefits from 1 practitioner Practice locations: Covington, LA |
National Provider Directory
National Provider DirectoryPractitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633996800000",
"number": "1083376594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 CHURCHILL DOWNS DR",
"city": "BUSH",
"state": "LA",
"postal_code": "704314504",
"telephone_number": "504-232-5695",
"fax_number": "985-781-0548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71107 HIGHWAY 21",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704337243",
"telephone_number": "985-781-0548",
"fax_number": "985-781-4319"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHRISTINA MCKINLEY",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A",
"authorized_official_last_name": "MCKINLEY",
"authorized_official_first_name": "CHRISTINA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "504-232-5695",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.