Active NPI
Brendan Micianizl McKenna, MD
- Obstetrics & Gynecology Physician
- Ashland, KY
National Provider Identifier
1467528091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 34006
- Practice address
- 2501 Lexington Ave
Ashland, KY 41101 - Phone
- (606) 329-0890
- Fax
- (606) 329-0904
- NPI assigned
- Nov 27, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 34006 | KY | Primary |
Addresses
Primary practice location
2501 Lexington Ave
Ashland, KY 41101
Mailing address
PO Box 513
Ashland, KY 41105
Phone (606) 329-0890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64340060 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467528091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 513",
"city": "ASHLAND",
"state": "KY",
"postal_code": "41105",
"telephone_number": "606-329-0890",
"fax_number": "606-329-0904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 LEXINGTON AVE",
"city": "ASHLAND",
"state": "KY",
"postal_code": "41101",
"telephone_number": "606-329-0890",
"fax_number": "606-329-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA",
"first_name": "BRENDAN",
"middle_name": "MICIANIZL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "KY",
"license": "34006",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64340060",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.