Individual provider Active NPI

Molly Katherine McKinney

  • Family Nurse Practitioner
  • Arnold, MD
National Provider Identifier
1649657982
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC001487 Issued in MD
Practice address
1300 Ritchie Hwy Ste B
Arnold, MD 21012-2244
Phone
(410) 793-5212
NPI assigned
May 6, 2015
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC001487 MD Primary

Addresses

Primary practice location

1300 Ritchie Hwy Ste B
Arnold, MD 21012-2244

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6524

Other practice location 1

555 Cynwood Dr
Easton, MD 21601-3801
Phone (410) 820-7270

Other identifiers 1

IdentifierTypeStateIssuer
964024000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150918002178 MD Practitioner - Nurse Practitioner 8628385929 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC001487MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Aug 3, 2015 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Aug 3, 2015 Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

555 Cynwood Dr
Easton, MD 21601
Phone (410) 810-0767

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1649657982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6524",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 RITCHIE HWY STE B",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122244",
            "telephone_number": "410-793-5212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Cynwood Dr",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216013801",
            "country_code": "US",
            "telephone_number": "410-820-7270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "MOLLY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC001487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "964024000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MD

Sources for this page

Verify at the official NPI Registry.