Rickanesha McKinney, HAIR LOSS SP

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

C58596 Issued in NC

Practice address

1020 S Breazeale Ave
Mount Olive, NC 28365-8572

Phone

(919) 920-3923

NPI assigned

Jan 25, 2021

Last updated

Jan 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1639769532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MENCY PL",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283652801",
            "telephone_number": "919-920-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S BREAZEALE AVE",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283658572",
            "telephone_number": "919-920-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "RICKANESHA",
        "credential": "HAIR LOSS SP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NC",
            "license": "C58596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carvin Lee Lucas
• Lauren Drew Marshall, ATC
• Xalicia McCollum, PTA
• Sandra McCoy, MA QP
• Karmashia Griffin McDuffie
• Patrick Michael McLaren, O.D.
• Edgbert Ray McLemore Jr., RPH
• Oscar Mojica
• Jessi Brooke Morgan, PHARMD
• Iman Motamed, DC

• Customized Equipment (DME) in Mount Olive, NC
• Providers in Mount Olive, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.