Jim McKinley, M.D., PLLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

H4539 Issued in TX

Legal business name

JIM MCKINLEY, M.D., PLLC

Practice address

1814 Roseland Blvd
Tyler, TX 75701-4234

Phone

(903) 780-4871

Fax

(888) 242-8720

NPI assigned

Sep 24, 2008

Last updated

Jan 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Wayne McKinley, M.D.NPI 1902896863

Title

M.D./Owner

Phone

(903) 780-4871

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Wayne McKinley, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Tyler, TX
  • NPI 1902896863
  Authorized official Same address or phone

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1528218740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 OLD BULLARD RD",
            "address_2": "PMB 56",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034340",
            "telephone_number": "903-780-4871",
            "fax_number": "888-242-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 ROSELAND BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014234",
            "telephone_number": "903-780-4871",
            "fax_number": "888-242-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM MCKINLEY, M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "903-780-4871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "H4539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alpesh R Jethva, M.D.
• Gina M. Jetter, MD
• Nikkia Jiles, LCSW
• Rachel Jiles
• Tatjuana Rachell Jiles
• Madeline Jimenez-Torres, M. D.
• Tyresa Jimmerson
• JK7 Promisland, Inc.
• JKM Homecare (Brightstar Care of Tyler Longview)
• JMC Professional Surgical Associate, PLLC

• Sports Medicine (Family Medicine) Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Sports Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.