Individual provider Active NPI

Juankee Jevonne McKinney, PH.D.

  • Specialist
  • Saint Louis, MO
National Provider Identifier
1679786032
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
01734 Issued in MO
Practice address
4144 Lindell Blvd
Suite 501
Saint Louis, MO 63108-2927
Phone
(314) 531-4743
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 01734 MO Primary

Addresses

Primary practice location

4144 Lindell Blvd
Suite 501
Saint Louis, MO 63108-2927

Mailing address

5714 Bartmer Ave
Saint Louis, MO 63112-2811
Phone (314) 454-1267

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091006000600 MO Practitioner - Clinical Psychologist 5799821658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1129 Macklind Ave
Saint Louis, MO 63110-1440
Phone 3145340200415

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01734MOMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Behavioral Medicine Institute Inc CurrentSince Sep 1, 2009 Accepting new patients
St. Louis Behavioral Medicine Institute Inc CurrentSince Sep 1, 2009 Accepting new patients

Locations

1129 Macklind Ave
Saint Louis, MO 63110
Phone (314) 534-0200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1679786032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 BARTMER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122811",
            "telephone_number": "314-454-1267",
            "fax_number": "314-454-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 LINDELL BLVD",
            "address_2": "SUITE 501",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082927",
            "telephone_number": "314-531-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JUANKEE",
        "middle_name": "JEVONNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "01734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.