Active NPI
William Martin McKinnon, MD
- Vascular Surgery Physician
- Atlanta, GA
National Provider Identifier
1477631885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 17233
- Practice address
- 550 Peachtree St NE
Suite 1085
Atlanta, GA 30308-2232 - Phone
- (404) 681-3190
- Fax
- (404) 681-3193
- NPI assigned
- Nov 2, 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 |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 17233 | GA | Primary |
Addresses
Primary practice location
550 Peachtree St NE
Suite 1085
Atlanta, GA 30308-2232
Mailing address
550 Peachtree St NE
Suite 1085
Atlanta, GA 30308-2232
Phone (404) 681-3190
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 581376411 | Other | CIGNA | |
| 770002368 | Other | MEDICARE RR | |
| 214476 | Other | GA | BLUE CROSS BLUE SHIELD |
| 578663 | Other | GA | AETNA |
| 00178725B | Medicaid | GA | |
| 1705837 | Other | 1ST HEALTH |
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": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477631885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 PEACHTREE ST NE",
"address_2": "SUITE 1085",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303082232",
"telephone_number": "404-681-3190",
"fax_number": "404-681-3193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 PEACHTREE ST NE",
"address_2": "SUITE 1085",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303082232",
"telephone_number": "404-681-3190",
"fax_number": "404-681-3193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNON",
"first_name": "WILLIAM",
"middle_name": "MARTIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "GA",
"license": "17233",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "581376411",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "770002368",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "214476",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "578663",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00178725B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1ST HEALTH",
"identifier": "1705837",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
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.