Colleen J McKinney, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35177063M Issued in OH

Practice address

540 S Trimble Rd
Mansfield, OH 44906-3418

Phone

(419) 522-5454

Fax

(419) 522-2981

NPI assigned

Jan 26, 2007

Last updated

Mar 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Community Practices, LLC

  • Pediatrics Physician
  • Mansfield, OH
  • NPI 1386031896
  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1275689788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 STURGES AVE STE 1",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032399",
            "telephone_number": "419-522-5454",
            "fax_number": "419-522-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 S TRIMBLE RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063418",
            "telephone_number": "419-522-5454",
            "fax_number": "419-522-2981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W Smiley Ave",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "OH",
            "postal_code": "448752130",
            "country_code": "US",
            "telephone_number": "419-342-2812",
            "fax_number": "419-342-2818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "COLLEEN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35177063M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2230446",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allyssa Marie McKee
• Valerie Kay McKelvey, RD
• Aimee McKenzie, R.N.
• Kimberly Renee McKenzie I
• Ann Denise McKinley, PT
• Jill M. McKinnon
• Shauna Kay McLain, D.C.
• Tawana Mechelle McLaurin
• Terri McLeod, MA, CCC/SLP
• Marcus McLittle, MSW, LICDC, LSW

• Pediatrics Physician in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.