John Paul McKenna Jr., MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

13585 Issued in MS

Practice address

101 Bodin Cir
60 MDG/Sgomm
Travis Afb, CA 94535-1809

Phone

(707) 423-5011

NPI assigned

Oct 11, 2005

Sex

Male

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 MT

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

Interoperability endpoints

• Direct secure messaging: jmckenna97479@direct.renown.org
• Direct secure messaging: jmckenna418606@wm.providencedirect.org

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

• Community Hospital of Anaconda

  • Critical Access Hospital
  • Anaconda, MT
  • NPI 1205887924
  Medicare reassignment NPD
• Community Hospital of Anaconda

  • Family Medicine Physician
  • Anaconda, MT
  • NPI 1538597703
  Medicare reassignment NPD
• Community Hospital of Anaconda

  • Surgery Physician
  • Anaconda, MT
  • NPI 1023623675
  NPD
• Community Hospital of Anaconda

  • Family Medicine Physician
  • Butte, MT
  • NPI 1205239076
  NPD
• Community Hospital of Anaconda

  • Family Medicine Physician
  • Anaconda, MT
  • NPI 1336244797
  NPD
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)
• Community Hospital of Anaconda

  • Pediatric Adolescent Medicine Physician
  • Anaconda, MT
  • NPI 1992838288
  NPD (past)
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1376531665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "60 MDG/SGOMM",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "60 MDG/SGOMM",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Anaconda",
            "state": "MT",
            "postal_code": "597111900",
            "country_code": "US",
            "telephone_number": "406-563-8686",
            "fax_number": "406-563-8691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MS",
            "license": "13585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376531665",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher O'Neal McCarty, CRNA, DNP
• Lauren McCullough, PTA
• Joseph Harris McDermott, M.D.
• Michael Andrew McGarvey, M.D.
• Amanda Sue McGee
• John McKeon, MD
• Connor McKinney, DO
• Shawn Regina McMahan
• Joseph Benjamin McNeal V, MD
• Kimbray Nichole McNeal, LCSW

• Endocrinology, Diabetes & Metabolism Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.