Active NPI
Greg McKinnon, LPN
- Licensed Practical Nurse
- Stanwood, WA
National Provider Identifier
1477977015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP60035217
- Practice address
- 26920 Pioneer Hwy
Stanwood, WA 98292-9548 - Phone
- (360) 629-1218
- Fax
- (366) 629-1242
- NPI assigned
- Feb 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP60035217 | WA | Primary |
Addresses
Primary practice location
26920 Pioneer Hwy
Stanwood, WA 98292-9548
Mailing address
26920 Pioneer Hwy
Stanwood, WA 98292-9548
Phone (360) 629-1218
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP60035217 | WA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1477977015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26920 PIONEER HWY",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982929548",
"telephone_number": "360-629-1218",
"fax_number": "366-629-1242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26920 PIONEER HWY",
"city": "STANWOOD",
"state": "WA",
"postal_code": "982929548",
"telephone_number": "360-629-1218",
"fax_number": "366-629-1242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNON",
"first_name": "GREG",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-18",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP60035217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.