Individual provider Active NPI

Sandra Darby McKee, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1700369378
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-154029 Issued in AL
Practice address
12301 Wilshire Blvd Ste 512
Los Angeles, CA 90025-1053
Phone
(205) 283-1839
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-154029 AL Primary

Addresses

Primary practice location

12301 Wilshire Blvd Ste 512
Los Angeles, CA 90025-1053

Mailing address

255 Indian Creek TRL
Warrior, AL 35180-5311
Phone (205) 283-1839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210920001817 CA Practitioner - Nurse Practitioner 0345588455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mellow Medical Inc a Professional CorporationGroup PAC ID 3375767403, 30 clinicians

Practice addresses (Care Compare)

12301 Wilshire Blvd
Suite 512
Los Angeles, CA 90025-1053
Phone (888) 684-2779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation Psychiatry CurrentSince Sep 3, 2021 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • Direct secure messaging: darby.mckee.1@9357.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1700369378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 INDIAN CREEK TRL",
            "city": "WARRIOR",
            "state": "AL",
            "postal_code": "351805311",
            "telephone_number": "205-283-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD STE 512",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251053",
            "telephone_number": "205-283-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "SANDRA",
        "middle_name": "DARBY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-154029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.