Individual provider Active NPI

Jared Stewart McKinnon, M.D.

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1528405578
Registry record updated Jun 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
35731 Issued in SC
Practice address
169 Ashley Ave
Room 202 Main Hospital Msc333
Charleston, SC 29425-8905
Phone
(843) 792-2322
NPI assigned
May 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X LL35731 SC
Anesthesiology Physician 207L00000X 35731 SC Primary

Addresses

Primary practice location

169 Ashley Ave
Room 202 Main Hospital Msc333
Charleston, SC 29425-8905

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20170731000208 SC Practitioner - Anesthesiology 1759670771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35731SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol Anesthesiology CurrentSince Jun 28, 2017 Accepting new patients
University Medical Associates of the Medical University of South Carol Anesthesiology CurrentSince Jun 28, 2017 Accepting new patients

Locations

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1528405578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "JARED",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-31",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "LL35731",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "35731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.