Individual provider Active NPI

Kenneth H. McKneely Sr.

  • Pharmacist
  • Fredericksburg, VA
National Provider Identifier
1174821227
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202004426 Issued in VA
Practice address
11129 Gordon Rd
Fredericksburg, VA 22407-1714
Phone
(540) 785-6634
Fax
(540) 785-6671
NPI assigned
Mar 14, 2011
Last updated
Mar 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202004426 VA Primary

Addresses

Primary practice location

11129 Gordon Rd
Fredericksburg, VA 22407-1714

Mailing address

7212 Cattail CT
Fredericksburg, VA 22407-2503
Phone (540) 845-7212

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0202004426VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1174821227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 CATTAIL CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072503",
            "telephone_number": "540-845-7212",
            "fax_number": "540-785-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11129 GORDON RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224071714",
            "telephone_number": "540-785-6634",
            "fax_number": "540-785-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKNEELY",
        "first_name": "KENNETH",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-14",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202004426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; 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.