Active NPI
McKayla M Dinwiddie, MD
- Family Medicine Physician
- O Fallon, MO
National Provider Identifier
1194429290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2026028283
- Practice address
- 2299 Technology Dr Ste 320
O Fallon, MO 63368-7341 - Phone
- (636) 695-0535
- Fax
- (636) 695-0537
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230621001669 | WI | Order and Referring Only - Family Practice | 3870951015 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Specialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2026028283 | MO | Primary |
| Family Medicine Physician | 207Q00000X | 100277 | WI | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
NPPES NPI RegistryPrimary practice location
2299 Technology Dr Ste 320
O Fallon, MO 63368-7341
Mailing address
PO Box 959354
Saint Louis, MO 63195-9354
Phone (636) 695-0535
Other practice location 1
800 West Ave S
LA Crosse, WI 54601-8806
Phone (608) 785-0940
Electronic endpoints 2
NPPES NPI Registry| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) | |
| Direct Messaging Address | mdinwiddie1950128@ehrdirect.mayoclinicmsg.org |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 30, 2026.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1194429290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 959354",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631959354",
"telephone_number": "636-695-0535",
"fax_number": "636-695-0537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2299 TECHNOLOGY DR STE 320",
"city": "O FALLON",
"state": "MO",
"postal_code": "633687341",
"telephone_number": "636-695-0535",
"fax_number": "636-695-0537"
}
],
"practiceLocations": [
{
"address_1": "800 West Ave S",
"address_purpose": "LOCATION",
"city": "LA Crosse",
"state": "WI",
"postal_code": "546018806",
"country_code": "US",
"telephone_number": "608-785-0940",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DINWIDDIE",
"first_name": "MCKAYLA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-30",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2026028283",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "100277",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2299 Technology Dr Ste 320",
"city": "O Fallon",
"state": "MO",
"country_code": "US",
"postal_code": "633687341",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdinwiddie1950128@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "800 West Ave S",
"city": "LA Crosse",
"state": "WI",
"country_code": "US",
"postal_code": "546018806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.