Kenneth Walter McKinley, M.D.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

MD046009 Issued in DC

Practice address

111 Michigan Ave NW
Washington, DC 20010

Phone

(202) 476-4177

NPI assigned

May 4, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Children'S Hospital

  • Children's Hospital
  • Washington, DC
  • NPI 1912939703
  Medicare reassignment NPD
• Children'S Hospital

  • Pediatrics Physician
  • Washington, DC
  • NPI 1780800128
  NPD
• Children'S Hospital

  • Community/Retail Pharmacy
  • Silver Spring, MD
  • NPI 1326878349
  NPD

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1457610875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 WEBSTER ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200117328",
            "telephone_number": "570-594-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-476-4177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3959 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100321559",
            "country_code": "US",
            "telephone_number": "212-305-9825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "KENNETH",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "57008",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "57008",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "DC",
            "license": "MD046009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latrinia Teretha McKesson, HHA
• Nicole McKesson
• William McKindley-Ward, LGSW
• Lynn J. McKinley-Grant, MD
• Katrice McKinley
• Lakeisha D McKinley
• Reginald McKinley
• Arthur Lorenzo McKinney, D.D.S.
• Ava Geneva McKinney
• Darlene McKinney

• Pediatric Emergency Medicine (Pediatrics) Physician in Washington, DC
• Providers in Washington, DC by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.