Individual provider Active NPI

Michael Phillip Kinney

  • Psychiatry Physician
  • Spokane, WA
National Provider Identifier
1144857012
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD61377878 Issued in WA
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-4744
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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
Psychiatry Physician 2084P0800X MD61377878 WA Primary

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241205001036 WY Practitioner - Psychiatry 1759747058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Washington School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Horn Health NetworkGroup PAC ID 1254476484, 84 clinicians
Memorial Hospital of Sheridan CountyGroup PAC ID 2163405440, 90 clinicians

Practice addresses (Care Compare)

1333 W 5TH St
Sheridan, WY 82801-2752
Phone (307) 675-2674

1401 W 5TH St
Sheridan, WY 82801-2705
Phone (307) 672-1000

Hospital & facility affiliations

  • Sheridan Memorial Hospital Hospital, Sheridan, WY, CCN 530006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Big Horn Health Network CurrentSince Nov 1, 2024 Accepting new patients
Memorial Hospital of Sheridan County Past Accepting new patients

Locations

1333 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000

1401 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000

1333 W 5th St
Ste 110
Sheridan, WY 82801
Phone (307) 675-4610

1333 W 5th St
Ste 200
Sheridan, WY 82801
Phone (307) 673-3181

Organizations & group practices 2

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 1

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1144857012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "MICHAEL",
        "middle_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61377878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.