Organization Active NPI

McKenney Medical Group, PLLC

Doing business as Holland Medical Center

  • Family Medicine Physician
  • Suffolk, VA
National Provider Identifier
1548463185
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102037167 Issued in VA
Legal business name
MCKENNEY MEDICAL GROUP, PLLC
Doing business as
Holland Medical Center
Practice address
6712A S Quay Rd
Suffolk, VA 23437-8697
Phone
(757) 657-9595
Fax
(757) 657-9950
NPI assigned
Jun 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Julian Dew McKenney Jr., D.O.
Title
Owner
Phone
(757) 657-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 0102037167 VA Primary

Addresses

Primary practice location

6712A S Quay Rd
Suffolk, VA 23437-8697

Mailing address

6712A S Quay Rd
Suffolk, VA 23437-8697
Phone (757) 657-9595

Other identifiers 1

IdentifierTypeStateIssuer
0102037167OtherVASTATE LICENSE

Other names 1

  • Holland Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

6712A S Quay Rd
Suffolk, VA 23437
Phone (757) 657-9595

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1548463185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712A S QUAY RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234378697",
            "telephone_number": "757-657-9595",
            "fax_number": "757-657-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712A S QUAY RD",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234378697",
            "telephone_number": "757-657-9595",
            "fax_number": "757-657-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENNEY MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MCKENNEY",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "DEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-657-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102037167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0102037167",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holland Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.