McKinley Medical Supply, Inc

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

MCKINLEY MEDICAL SUPPLY, INC

Practice address

210 Nizhoni Blvd
Gallup, NM 87301-5744

Phone

(505) 722-4311

Fax

(505) 722-6260

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Gretchen S. Bigley

Title

President

Phone

(505) 722-4311

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1477653616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2997",
            "address_2": "210 NIZHONI BLVD.",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873052997",
            "telephone_number": "505-722-4311",
            "fax_number": "505-722-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015744",
            "telephone_number": "505-722-4311",
            "fax_number": "505-722-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKINLEY MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "BIGLEY",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-722-4311",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F4579",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "T656",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117855",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Forde McIver III
• David C McKenzie, MD
• Marian H McKenzie, CNP
• McKinley Counseling Center
• McKinley County
• Chante Alise McKinley
• Jane Eileen McNamee, RN
• William John McNicholas II
• Kevin Edward McPadden
• Lisa Andrea McRae, RN

• Oxygen Equipment & Supplies (DME) in Gallup, NM
• Providers in Gallup, NM by specialty
• Oxygen Equipment & Supplies (DME) in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.