John Davis McKellar, PH.D.

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

18966 Issued in CA

Practice address

15047 Los Gatos Blvd
Suite 200
Los Gatos, CA 95032-2054

Phone

(408) 364-6799

Fax

(408) 378-4510

NPI assigned

Feb 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Integrated Pain Management Medical Group, Inc.

  dba Boomerang Healthcare

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1922198779
  Medicare reassignment NPD

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1184893778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15047 LOS GATOS BLVD",
            "address_2": "SUITE 200",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322054",
            "telephone_number": "408-364-6799",
            "fax_number": "408-378-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15047 LOS GATOS BLVD",
            "address_2": "SUITE 200",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322054",
            "telephone_number": "408-364-6799",
            "fax_number": "408-378-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELLAR",
        "first_name": "JOHN",
        "middle_name": "DAVIS",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "18966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Robert McGirt III
• Kirsten McGlynn, CMT
• Judy Lynne McGrain, D.C.
• Trinity McGuire
• Maya McIntyre
• Maryanne McKowen, MFT
• Michelle Kathleen McNerney, LCSW
• Cassidy Ellyn McWilliams, DPT
• Meagan M. Littlepage, M.D., Inc.
• Deanna Meas

• Addiction (Substance Use Disorder) Psychologist in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Addiction (Substance Use Disorder) Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.