Active NPI
Gregory James McKinney, CRNA
- Certified Registered Nurse Anesthetist
- Jackson, WY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 41799.1797
- Practice address
- 625 E Broadway Ave
Jackson, WY 83001-8642 - Phone
- (307) 739-7218
- Fax
- (307) 739-7446
- NPI assigned
- Aug 5, 2013
- Last updated
- Feb 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 41799.1797 | WY | Primary |
Addresses
Primary practice location
625 E Broadway Ave
Jackson, WY 83001-8642
Mailing address
625 E Broadway Ave Box 428
Jackson, WY 83001-0428
Phone (307) 739-7218
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150883100 | Medicaid | WY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gmckinney@sjmc.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, AK
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3300 Providence Dr
Suite 207
Anchorage, AK 99508-4620
Phone (907) 561-0005
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ncap Imh, LLC | Current | Accepting new patients | |
| Providence Anchorage Anesthesia Medical Group, P.C. | Current | Accepting new patients |
Locations
3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111
3300 Providence Dr
Ste 207
Anchorage, AK 99508
Phone (907) 279-0555
3702 Automation Way
Ste 103
Fort Collins, CO 80525
Phone (970) 495-6201
255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141
Interoperability endpoints
- gmckinney@sjmc.cernerdirect.com
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.
-
- Anesthesiology Physician
- Anchorage, AK
- NPI 1659368397
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Alaska Medical Center
- General Acute Care Hospital
- Anchorage, AK
- NPI 1053363119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613347200000",
"number": "1376975037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 E BROADWAY AVE BOX 428",
"city": "JACKSON",
"state": "WY",
"postal_code": "830010428",
"telephone_number": "307-739-7218",
"fax_number": "307-739-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 E BROADWAY AVE",
"city": "JACKSON",
"state": "WY",
"postal_code": "830018642",
"telephone_number": "307-739-7218",
"fax_number": "307-739-7446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNEY",
"first_name": "GREGORY",
"middle_name": "JAMES",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-05",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WY",
"license": "41799.1797",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150883100",
"state": "WY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gmckinney@sjmc.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Messaging Address for St John's Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "625 E Broadway Ave",
"city": "Jackson",
"state": "WY",
"country_code": "US",
"postal_code": "830018642",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jackson, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.