Organization Active NPI

McKinnon Eye Clinic, P.a.

  • Ophthalmology Physician
  • Taylorsville, NC
National Provider Identifier
1083903074
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MCKINNON EYE CLINIC, P.A.
Practice address
399 3Rd Ave SW
Taylorsville, NC 28681-4180
Phone
(828) 632-9005
NPI assigned
Mar 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Authorized official

Name
Steve McKinnon, M.D.
Title
President/Treasurer
Phone
(704) 873-1463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

399 3Rd Ave SW
Taylorsville, NC 28681-4180

Mailing address

PO Box 991
Statesville, NC 28687-0991
Phone (704) 873-1463

Other identifiers 1

IdentifierTypeStateIssuer
8957138MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1083903074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 991",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286870991",
            "telephone_number": "704-873-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 3RD AVE SW",
            "city": "TAYLORSVILLE",
            "state": "NC",
            "postal_code": "286814180",
            "telephone_number": "828-632-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKINNON EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "MCKINNON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT/TREASURER",
        "authorized_official_telephone_number": "704-873-1463",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8957138",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.