Individual provider Active NPI

Marsha Joellyn McKay, D.O.

  • Family Medicine Physician
  • Twain Harte, CA
National Provider Identifier
1558384206
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5680 Issued in CA
Practice address
18711 Tiffeni Dr
Suite 16
Twain Harte, CA 95383-9590
Phone
(209) 586-2000
Fax
(209) 586-2075
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A5680 CA Primary

Addresses

Primary practice location

18711 Tiffeni Dr
Suite 16
Twain Harte, CA 95383-9590

Mailing address

18711 Tiffeni Dr
Suite 16
Twain Harte, CA 95383-9590
Phone (209) 586-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1558384206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18711 TIFFENI DR",
            "address_2": "SUITE 16",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839590",
            "telephone_number": "209-586-2000",
            "fax_number": "209-586-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18711 TIFFENI DR",
            "address_2": "SUITE 16",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839590",
            "telephone_number": "209-586-2000",
            "fax_number": "209-586-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "MARSHA",
        "middle_name": "JOELLYN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twain Harte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.