Chontay L McKay, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2015043224 Issued in MO

Practice address

601 James R Thompson Blvd
Building D, Suite 2015
East Saint Louis, IL 62201-1129

Phone

(618) 482-6959

Fax

(618) 482-8311

NPI assigned

Jul 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Southern Illinois Regional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • East Saint Louis, IL
  • NPI 1336258540
  NPD (past)

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1649622622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 TIMBERWOOD TRAILS DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317511",
            "telephone_number": "314-313-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JAMES R THOMPSON BLVD",
            "address_2": "BUILDING D, SUITE 2015",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622011129",
            "telephone_number": "618-482-6959",
            "fax_number": "618-482-8311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Timberwood Trails Dr",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630317511",
            "country_code": "US",
            "telephone_number": "314-313-2804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "CHONTAY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-01",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014333",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2015043224",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015043224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.