Individual provider Active NPI

Shahlini Kay McKinley, RN

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1720308430
Registry record updated Apr 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71012106A Issued in IN
Practice address
3140 Arundel LN
Indianapolis, IN 46222-1815
Phone
(317) 449-9704
Fax
(317) 534-3159
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 28146540A IN
Nurse Practitioner 363L00000X 71012106A IN
Gerontology Nurse Practitioner 363LG0600X 71012106A IN Primary

Addresses

Primary practice location

3140 Arundel LN
Indianapolis, IN 46222-1815

Mailing address

3140 Arundel LN
Indianapolis, IN 46222-1815
Phone (317) 439-9207

Other practice location 1

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220125000170 IN Practitioner - Nurse Practitioner 3779676911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RP Care LLCGroup PAC ID 9234424813, 31 clinicians

Practice addresses (Care Compare)

4954 E 56TH St
Suite 11 Indy DRS
Indianapolis, IN 46220-5769
Phone (800) 561-2078

6326 Constitution Dr
Fort Wayne, IN 46804-1518
Phone (260) 515-3275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28146540AINMDAdministrator Registered Nurse
71012106AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McKinley Rounding Providers LLC CurrentSince Dec 27, 2021 Accepting new patients
RP Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Total Renal Care Inc PastSince Mar 1, 2013 Accepting new patients

Locations

6326 Constitution Dr
Fort Wayne, IN 46804
Phone (260) 515-3275

4954 E 56th St
Ste 11
Indianapolis, IN 46220
Phone (317) 833-0973

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713052800000",
    "number": "1720308430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 ARUNDEL LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221815",
            "telephone_number": "317-439-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 ARUNDEL LN",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462221815",
            "telephone_number": "317-449-9704",
            "fax_number": "317-534-3159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6326 Constitution Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468041518",
            "country_code": "US",
            "telephone_number": "260-515-3275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "SHAHLINI",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2024-04-14",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IN",
            "license": "28146540A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012106A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71012106A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.