Individual provider Active NPI

Robert Menzie McKim, M.D.

  • Family Medicine Physician
  • Baker City, OR
National Provider Identifier
1376577940
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD06674 Issued in OR
Practice address
3175 Pocahontas Rd
Baker City, OR 97814-1434
Phone
(541) 523-4415
Fax
(541) 523-2399
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 MD06674 OR Primary

Addresses

Primary practice location

3175 Pocahontas Rd
Baker City, OR 97814-1434

Mailing address

3175 Pocahontas Rd
Baker City, OR 97814-1434
Phone (541) 523-4415

Other identifiers 2

IdentifierTypeStateIssuer
230847MedicaidOR
227616MedicaidOR

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6674ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Baker Clinic, LLP CurrentSince Jul 1, 1966 Accepting new patients

Locations

3175 Pocahontas Rd
Baker City, OR 97814
Phone (208) 302-2200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1523/brand/1/csg/23/fhir/r4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376577940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 POCAHONTAS RD",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141434",
            "telephone_number": "541-523-4415",
            "fax_number": "541-523-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 POCAHONTAS RD",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141434",
            "telephone_number": "541-523-4415",
            "fax_number": "541-523-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIM",
        "first_name": "ROBERT",
        "middle_name": "MENZIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD06674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230847",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227616",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.