Individual provider Active NPI

Donnie Ray McKinney Jr., PT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1134520588
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25186 Issued in MD
Practice address
6500 Eastern Ave
Suite E & F
Baltimore, MD 21224-2900
Phone
(410) 633-3670
Fax
(410) 633-3674
NPI assigned
Sep 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25186 MD Primary

Addresses

Primary practice location

6500 Eastern Ave
Suite E & F
Baltimore, MD 21224-2900

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25186MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1134520588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EASTERN AVE",
            "address_2": "SUITE E & F",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242900",
            "telephone_number": "410-633-3670",
            "fax_number": "410-633-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "DONNIE",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.