Susanne S McKinney, N.P.

Primary specialty

Gastroenterology Registered NurseTaxonomy code 163WG0100X

License

5221 Issued in TN

Practice address

10461 Wallace Alley St
Kingsport, TN 37663-3936

Phone

(423) 279-1400

Fax

(423) 279-1410

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Susanne S Bradford Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443657600000",
    "number": "1497756787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400",
            "fax_number": "423-279-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400",
            "fax_number": "423-279-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "SUSANNE",
        "middle_name": "S",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2015-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "TN",
            "license": "5221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3908885",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNE",
            "last_name": "BRADFORD",
            "middle_name": "S",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley McKamey, RN
• McKee Builders, Inc
• Jeffrey McKee
• Lisa A McKinney Smith, DO
• Gabriel Micah McKinney, BA
• Kayla Ashlee McKissick, M.A.
• Angela Renee McLain, RN
• Scott D McLain, MD
• Randy K McLaughlin, MD
• Steven J McLaughlin, PA

• Gastroenterology Registered Nurse in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Gastroenterology Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.