Individual provider Active NPI

Tyler Austin McKinney, DO

  • Emergency Medicine Physician
  • Lawton, OK
National Provider Identifier
1144802554
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7650 Issued in OK
Practice address
3401 W Gore Blvd
Lawton, OK 73505-6332
Phone
(580) 585-5545
NPI assigned
Apr 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 7650 OK Primary

Addresses

Primary practice location

3401 W Gore Blvd
Lawton, OK 73505-6332

Mailing address

3401 W Gore Blvd
Lawton, OK 73505-6332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230104002166 TX Practitioner - Emergency Medicine 0941685259 Reassigns benefits to 1 organization
I20230417001804 OK Practitioner - Emergency Medicine 0941685259 Reassigns benefits to 4 organizations
I20260528002699 TN Practitioner - Emergency Medicine 0941685259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7650OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Emergency Services PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Centurion Emergency Partners LLC Emergency Medicine CurrentSince Nov 5, 2024 Accepting new patients
Arbuckle Memorial Hospital Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Dec 21, 2022 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Dec 21, 2022 Accepting new patients
Elite Hospital Partners of Oklahoma Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Comanche County Hospital Authority Past Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients
Choctaw Nation of Oklahoma Past Accepting new patients

Locations

1415 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-6657

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1144802554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-585-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "TYLER",
        "middle_name": "AUSTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-25",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "7650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.