Individual provider Active NPI

Kevin Edward McKinney, CRNP

  • Adult Health Nurse Practitioner
  • Huntingdon, PA
National Provider Identifier
1407316755
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP020164 Issued in PA
Practice address
51 Pennsylvania Ave
Huntingdon, PA 16652-1204
Phone
(814) 501-7090
Fax
(814) 643-3417
NPI assigned
Mar 22, 2019
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP020164 PA Primary

Addresses

Primary practice location

51 Pennsylvania Ave
Huntingdon, PA 16652-1204

Mailing address

51 Pennsylvania Ave
Huntingdon, PA 16652-1204
Phone (814) 501-7090

Other identifiers 1

IdentifierTypeStateIssuer
SP020164OtherPAPA SBON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240904001839 PA Practitioner - Nurse Practitioner 1254871379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Weight Loss LLC Adult Health CurrentSince May 26, 2024 Accepting new patients
Ars Treatment Centers, P.C. CurrentSince Jul 1, 2024 Accepting new patients
Ars Treatment Centers, P.C. CurrentSince Jul 1, 2024 Accepting new patients

Locations

220 S Main St
Ste A
Butler, PA 16001

51 Pennsylvania Ave
Huntingdon, PA 16652
Phone (814) 501-7090

655 Church St
Indiana, PA 15701
Phone (724) 465-0369

2317 E Westmoreland St
Philadelphia, PA 19134
Phone (215) 291-3115

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1407316755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PENNSYLVANIA AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166521204",
            "telephone_number": "814-501-7090",
            "fax_number": "814-643-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 PENNSYLVANIA AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166521204",
            "telephone_number": "814-501-7090",
            "fax_number": "814-643-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP020164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA SBON",
            "identifier": "SP020164",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, PA

Sources for this page

Verify at the official NPI Registry.