Individual provider Active NPI

Cheryl L McKee, P.A.-C

  • Medical Physician Assistant
  • White Bear Lake, MN
National Provider Identifier
1386645745
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
41 1853319 Issued in MN
Practice address
4465 White Bear Parkway
White Bear Lake, MN 55110
Phone
(651) 653-0062
Fax
(651) 653-0288
NPI assigned
Aug 9, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 41 1853319 MN Primary

Addresses

Primary practice location

4465 White Bear Parkway
White Bear Lake, MN 55110

Mailing address

4465 White Bear Parkway
White Bear Lake, MN 55110
Phone (651) 653-0062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000584 MN Practitioner - Physician Assistant 1052375250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aalfa Family Practice PAGroup PAC ID 7810954146, 7 clinicians

Practice addresses (Care Compare)

4465 White Bear Pkwy
Saint Paul, MN 55110-7623

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9940MNMDDentist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386645745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PARKWAY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "651-653-0062",
            "fax_number": "651-653-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 WHITE BEAR PARKWAY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "651-653-0062",
            "fax_number": "651-653-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "CHERYL",
        "middle_name": "L",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "41 1853319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

Verify at the official NPI Registry.