Malonnie L Kinnison, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

D0027477 Issued in MD

Practice address

4021 Avenue B
Scottsbluff, NE 69361-4602

Phone

(303) 761-9190

Fax

(303) 761-6278

NPI assigned

Jun 10, 2006

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

Credentials

Doctor of Medicine

State licenses

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.

• Radiology Imaging of Nebraska, LLC

  • Diagnostic Radiology Physician
  • Scottsbluff, NE
  • NPI 1184869901
  NPD (past)
• Advanced Radiology P a

  • Diagnostic Radiology Physician
  • Owings Mills, MD
  • NPI 1932167178
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1689615494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 E GEDDES AVE",
            "address_2": "SUITE 200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801123800",
            "telephone_number": "303-761-9190",
            "fax_number": "303-761-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 AVENUE B",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614602",
            "telephone_number": "303-761-9190",
            "fax_number": "303-761-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNISON",
        "first_name": "MALONNIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0027477",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "24920",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MD",
            "license": "D0027477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "439851300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Kicken, RN
• Kerri J Kilgore, PHARM.D.
• Bailee King
• Michael King
• Ronnesha King
• Kaylee Kinser
• Polli Kinsey, M.A.
• Robert Vernon Kirk, PSY.D.
• Michael Klein
• Bailey Kling, CSW

• Vascular & Interventional Radiology Physician in Scottsbluff, NE
• Providers in Scottsbluff, NE by specialty
• Vascular & Interventional Radiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; 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.