Active NPI
Dennis Russell McKinley, RPH
- Pharmacist
- La Mesa, CA
National Provider Identifier
1225119688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 33484
- Practice address
- 8010 Parkway Dr
La Mesa, CA 91942-2104 - Phone
- (619) 589-3467
- Fax
- (619) 589-3266
- NPI assigned
- Oct 18, 2006
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 33484 | CA | Primary |
Addresses
Primary practice location
8010 Parkway Dr
La Mesa, CA 91942-2104
Mailing address
8010 Parkway Dr
La Mesa, CA 91942-2104
Phone (619) 589-3467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33484 | Other | CA | PHARMACIST LICENSE |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33484 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225119688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8010 PARKWAY DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919422104",
"telephone_number": "619-589-3467",
"fax_number": "619-589-3266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8010 PARKWAY DR",
"city": "LA MESA",
"state": "CA",
"postal_code": "919422104",
"telephone_number": "619-589-3467",
"fax_number": "619-589-3266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINLEY",
"first_name": "DENNIS",
"middle_name": "RUSSELL",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "33484",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "33484",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.