Individual provider Active NPI

Donald Kenneth Pinckney, OT/L

  • Occupational Therapist
  • Logan, WV
National Provider Identifier
1326225772
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
440 Issued in WV
Practice address
506 Holly Ave
Logan, WV 25601-3306
Phone
(304) 752-2073
Fax
(304) 752-7471
NPI assigned
Jan 29, 2008
Last updated
Jan 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 440 WV Primary

Addresses

Primary practice location

506 Holly Ave
Logan, WV 25601-3306

Mailing address

60 9TH Ave
Saint Albans, WV 25177-2711
Phone (304) 752-2073

Other identifiers 1

IdentifierTypeStateIssuer
0159555000MedicaidWV

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

State licenses

LicenseStateTypeSpecialty
440WVMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1326225772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 9TH AVE",
            "city": "SAINT ALBANS",
            "state": "WV",
            "postal_code": "251772711",
            "telephone_number": "304-752-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 HOLLY AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013306",
            "telephone_number": "304-752-2073",
            "fax_number": "304-752-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCKNEY",
        "first_name": "DONALD",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159555000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.