Individual provider Active NPI

Jordan B McKinney, PA-C

  • Physician Assistant
  • Greenfield, IN
National Provider Identifier
1134525298
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002430A Issued in IN
Practice address
1300 Anderson Blvd
Greenfield, IN 46140-7934
Phone
(000) 000-0000
NPI assigned
Nov 17, 2014
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10002430A IN Primary
Medical Physician Assistant 363AM0700X 50004211 OH
Medical Physician Assistant 363AM0700X MA057073 PA

Addresses

Primary practice location

1300 Anderson Blvd
Greenfield, IN 46140-7934

Mailing address

1300 Anderson Blvd
Greenfield, IN 46140-7934

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180418002563 IN Practitioner - Physician Assistant 6406179225 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA057073PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients
Trinity West Past Accepting new patients
Pedestals for Womens Health LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jordan.mckinney.1@14940.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1134525298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ANDERSON BLVD",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461407934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANDERSON BLVD",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461407934",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JORDAN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-17",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002430A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50004211",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057073",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

Verify at the official NPI Registry.