Individual provider Active NPI

Cassidy Nicole McKinney, OD

  • Optometrist
  • Piqua, OH
National Provider Identifier
1104666940
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.007295 Issued in OH
Practice address
400 N Main St
Piqua, OH 45356-2318
Phone
(937) 773-8023
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.007295 OH Primary

Addresses

Primary practice location

400 N Main St
Piqua, OH 45356-2318

Mailing address

1205 Township Road 1656
Ashland, OH 44805-9453
Phone (419) 908-3784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821005049 OH Practitioner - Optometry 0648718627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Mid West Medical College, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 N Main St
Piqua, OH 45356-2318
Phone (937) 773-8023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.007295OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
McKinney Eyecare, LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

400 N Main St
Piqua, OH 45356
Phone (937) 538-8113

Organizations & group practices 1

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": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717286400000",
    "number": "1104666940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 TOWNSHIP ROAD 1656",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448059453",
            "telephone_number": "419-908-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453562318",
            "telephone_number": "937-773-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "CASSIDY",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piqua, OH

Sources for this page

Verify at the official NPI Registry.