Active NPI
Chris McKinney
- Dentist
- Poway, CA
National Provider Identifier
1164568812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53013
- Practice address
- 15525 Pomerado Rd,
Suite C-6
Poway, CA 92064 - Phone
- (858) 485-6600
- Fax
- (858) 673-5546
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 53013 | CA | Primary |
Addresses
Primary practice location
15525 Pomerado Rd,
Suite C-6
Poway, CA 92064
Mailing address
15525 Pomerado Rd,
Suite C-6
Poway, CA 92064
Phone (858) 485-6600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811472 | Other | CA | PROVIDER ID FOR UNITED CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53013 | CA | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1164568812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15525 POMERADO RD,",
"address_2": "SUITE C-6",
"city": "POWAY",
"state": "CA",
"postal_code": "92064",
"telephone_number": "858-485-6600",
"fax_number": "858-673-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15525 POMERADO RD,",
"address_2": "SUITE C-6",
"city": "POWAY",
"state": "CA",
"postal_code": "92064",
"telephone_number": "858-485-6600",
"fax_number": "858-673-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNEY",
"first_name": "CHRIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-29",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER ID FOR UNITED CO",
"identifier": "1811472",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.