Deborah Sue McKinnis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME57321 Issued in FL

Practice address

1344 22ND St S
St Petersburg, FL 33712-2744

Phone

(727) 824-8181

Fax

(727) 824-8134

NPI assigned

Jan 31, 2006

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Health Center of Pinellas Inc

  • Federally Qualified Health Center (FQHC)
  • Clearwater, FL
  • NPI 1467873315
  Medicare reassignment NPD
• Community Health Centers of Pinellas Inc.

  • Pharmacy
  • Clearwater, FL
  • NPI 1467273383
  NPD
• Community Health Centers of Pinellas Inc.

  • Federally Qualified Health Center (FQHC)
  • Largo, FL
  • NPI 1255319976

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1528039278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10549",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330549",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 22ND ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337122744",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNIS",
        "first_name": "DEBORAH",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME57321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053248700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Lee McKenna, MD
• Ariana McKeon, APRN
• Erin E McKinley, M.S.W.
• Scott D McKinley, DO
• Tracey Levone McKinney, NNP
• Bertha McKinnon
• Montego McKinnon Sr.
• Dadrian Kenisha McKoy
• Ava McLamb
• Raymond E. McLane, M.D.

• Pediatrics Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.