Individual provider Active NPI

Gregory Scott McKinney, MD

  • Family Medicine Physician
  • Malvern, AR
National Provider Identifier
1336547843
Registry record updated Dec 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-0856 Issued in AR
Practice address
100 Walco LN
Malvern, AR 72104-6793
Phone
(501) 337-8061
Fax
(501) 337-8043
NPI assigned
Dec 15, 2014
Last updated
Dec 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-0856 AR Primary

Addresses

Primary practice location

100 Walco LN
Malvern, AR 72104-6793

Mailing address

122 Calais Dr
Maumelle, AR 72113-6588
Phone (501) 590-8148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20181210001960 AR Practitioner - Family Practice 5890039317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Velocity Care Arkansas PLLCGroup PAC ID 9133360738, 3 clinicians

Practice addresses (Care Compare)

11600 Chenal Pkwy
Suite 5
Little Rock, AR 72211-3707
Phone (501) 221-1160

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-0856ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Daiya Healthcare PLLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1636 Higdon Ferry Rd
Hot Springs National Park, AR 71913
Phone (501) 520-2000

11120 NE 33rd Pl
Ste 202
Bellevue, WA 98004
Phone (206) 426-2584

Organizations & group practices 2

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": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1336547843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CALAIS DR",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721136588",
            "telephone_number": "501-590-8148",
            "fax_number": "501-337-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WALCO LN",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721046793",
            "telephone_number": "501-337-8061",
            "fax_number": "501-337-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-15",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-0856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.