NPIMap

Individual provider Active NPI

Mark Steven McKinnon, MD

  • Family Medicine Physician
  • Winters, TX
National Provider Identifier
1457326571
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M8827 Issued in TX
Practice address
7771 State Highway 153
Winters, TX 79567-7350
Phone
(325) 754-1317
Fax
(325) 754-1208
NPI assigned
Feb 22, 2006
Last updated
Jul 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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 M8827 TX Primary

Addresses

Primary practice location

7771 State Highway 153
Winters, TX 79567-7350

Mailing address

7771 State Highway 153
Winters, TX 79567-7350
Phone (325) 754-1317

Other identifiers 1

IdentifierTypeStateIssuer
100168190AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090520000441 TX Practitioner - Family Practice 9234288341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians
North Runnels County HospitalGroup PAC ID 6507757812, 11 clinicians

Practice addresses (Care Compare)

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

7571 State Hwy 153
Winters, TX 79567-7439
Phone 3257541500519

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21158OKMDPharmacist
M8827TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Runnels County Hospital CurrentSince Oct 31, 2010 Accepting new patients
North Runnels County Hospital Family Medicine CurrentSince Oct 31, 2010 Accepting new patients
North Runnels County Hospital Past Accepting new patients
North Runnels County Hospital Past Accepting new patients

Locations

7571 State Highway 153
Winters, TX 79567
Phone (325) 754-1317

7821 State Highway 153
Winters, TX 79567
Phone (325) 754-4553

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/northru-237b4f81

Organizations & group practices 4

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 6

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1457326571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7771 STATE HIGHWAY 153",
            "city": "WINTERS",
            "state": "TX",
            "postal_code": "795677350",
            "telephone_number": "325-754-1317",
            "fax_number": "325-754-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7771 STATE HIGHWAY 153",
            "city": "WINTERS",
            "state": "TX",
            "postal_code": "795677350",
            "telephone_number": "325-754-1317",
            "fax_number": "325-754-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M8827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100168190A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winters, TX

Sources for this page

Verify at the official NPI Registry.