John McKenna, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD211959 Issued in OR

Practice address

2801 N Gantenbein Ave
Portland, OR 97227-1623

Phone

(503) 413-4278

NPI assigned

Apr 13, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Obstetrics/Gynecology

Education

University of Texas Southwestern Medical School at Dallas, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 4587573001, shared by 3 NPIs, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmckennaagency253904@samhealth.direct-ci.com
• Direct secure messaging: jmckenna561190@direct.peacehealth.org

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  Medicare reassignment NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Multi-Specialty Clinic/Center
  • Florence, OR
  • NPI 1982774378
  Medicare reassignment NPD

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

• Peacehealth

  dba Peace Harbor Medical Center

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  Care Compare affiliation

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1316333610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-413-4278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Noble St",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997014948",
            "country_code": "US",
            "telephone_number": "907-459-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "59812",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD211959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1698149",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Michael McKeiver, DO
• Robert Smith McKelvey, MD
• Domenica Marie McKenna, PHARMD
• Emily McKenna
• Ian G. McKenna, MD
• Kimberly Anne McKenna, MD
• Roberta Lee McKenney
• Sydne McKennie
• Alison McKenzie, L.AC.
• Brian Lee McKenzie, QMHA

• Obstetrics & Gynecology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Obstetrics & Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.