Individual provider Active NPI

Robert James McKinney, DC

  • Chiropractor
  • Wagoner, OK
National Provider Identifier
1376550574
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3438 Issued in OK
Practice address
508 E Cherokee St
Wagoner, OK 74467-4710
Phone
(918) 485-1973
Fax
(918) 485-1979
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3438 OK Primary

Addresses

Primary practice location

508 E Cherokee St
Wagoner, OK 74467-4710

Mailing address

PO Box 1096
Wagoner, OK 74477-1096
Phone (918) 485-1973

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000489 OK Practitioner - Chiropractic 9739184615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13831 S Hwy 51
Coweta, OK 74429-7168
Phone (918) 279-1310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3438OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coweta Family Chiropractic Clinic PLLC CurrentSince Feb 2, 2007 Accepting new patients

Locations

13831 S State Highway 51
Coweta, OK 74429
Phone (918) 279-1310

13783 S State Highway 51
Coweta, OK 74429
Phone (918) 279-1310

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1376550574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1096",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744771096",
            "telephone_number": "918-485-1973",
            "fax_number": "918-485-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 E CHEROKEE ST",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674710",
            "telephone_number": "918-485-1973",
            "fax_number": "918-485-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wagoner, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.