NPIMap

Individual provider Active NPI

Marc R McKinley, D.O.

  • Nephrology Physician
  • Panama City, FL
National Provider Identifier
1225212285
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS14763 Issued in FL
Practice address
504 N Macarthur Ave
Panama City, FL 32401-3636
Phone
(850) 769-2158
NPI assigned
Dec 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58.002415 OH
Nephrology Physician 207RN0300X 34009847 OH
Nephrology Physician 207RN0300X OS14763 FL Primary

Addresses

Primary practice location

504 N Macarthur Ave
Panama City, FL 32401-3636

Mailing address

120 W 22ND St Ste 300
Oak Brook, IL 60523-4071
Phone (630) 573-5000

Other practice location 1

805 Columbia Rd Ste 101
Westlake, OH 44145-1461
Phone (216) 228-5500

Other identifiers 1

IdentifierTypeStateIssuer
66174MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210115000333 FL Practitioner - Nephrology 7911161781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Ohio University, College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard F Walker Jr MD Nephrology Associates PAGroup PAC ID 3779672720, 9 clinicians

Practice addresses (Care Compare)

504 N Macarthur Ave
Panama City, FL 32401-3636
Phone (850) 769-2158

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58.002415OHMDInternal Medicine Physician
OS14763FLMDNephrology Physician
34009847OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nani Lab LLC CurrentSince May 4, 2025 Accepting new patients
Nephrology Associates PA Nephrology CurrentSince Jan 1, 2021 Accepting new patients
Comprehensive Kidney Care, Inc. Internal Medicine Past Accepting new patients

Locations

504 N MacArthur Ave
Panama City, FL 32401
Phone (850) 769-2158

120 W 22nd St
Ste 300
Oak Brook, IL 60523
Phone (630) 974-5000

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1225212285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234071",
            "telephone_number": "630-573-5000",
            "fax_number": "630-368-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N MACARTHUR AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013636",
            "telephone_number": "850-769-2158"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Columbia Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441451461",
            "country_code": "US",
            "telephone_number": "216-228-5500",
            "fax_number": "216-227-2628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "MARC",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-26",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "58.002415",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "34009847",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "OS14763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66174",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.