Individual provider Active NPI

Michael Kenneth McKenery, MSN, CRNP

  • Nurse Practitioner
  • Butler, PA
National Provider Identifier
1275057911
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP017670 Issued in PA
Practice address
240 Pullman SQ Ste 255
Butler, PA 16001-5654
Phone
(724) 431-4170
NPI assigned
Aug 2, 2017
Last updated
Mar 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP017670 PA Primary
Registered Nurse 163W00000X RN697852 PA

Addresses

Primary practice location

240 Pullman SQ Ste 255
Butler, PA 16001-5654

Mailing address

240 Pullman SQ Ste 255
Butler, PA 16001-5654
Phone (724) 431-4170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180216000195 PA Practitioner - Nurse Practitioner 4183984933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN697852PAMDRegistered Nurse
SP017670PAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: michael.mckenery@upmcdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1275057911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PULLMAN SQ STE 255",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160015654",
            "telephone_number": "724-431-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PULLMAN SQ STE 255",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160015654",
            "telephone_number": "724-431-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENERY",
        "first_name": "MICHAEL",
        "middle_name": "KENNETH",
        "credential": "MSN, CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP017670",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN697852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.