Individual provider Active NPI

Emily L McKinney, PA-C

  • Physician Assistant
  • Conway, AR
National Provider Identifier
1720620818
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-864 Issued in AR
Practice address
550 Club LN
Conway, AR 72034-3681
Phone
(501) 329-1510
NPI assigned
Oct 10, 2019
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-864 AR Primary

Addresses

Primary practice location

550 Club LN
Conway, AR 72034-3681

Mailing address

550 Club LN
Conway, AR 72034-3681
Phone (501) 329-1510

Other names 1

  • Emily Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20191209000071 AR Practitioner - Physician Assistant 2668805581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

550 Club LN
Suite 1
Conway, AR 72034-3681
Phone (501) 329-1510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-864ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc CurrentSince Jan 2, 2020 Accepting new patients
Conway Regional Medical Center Inc. CurrentSince Jan 2, 2020 Accepting new patients
Conway Pain Clinic, PLLC CurrentSince Oct 13, 2019 Accepting new patients

Locations

550 Club Ln
Conway, AR 72034
Phone (501) 327-2414

550 Club Ln
Ste 1
Conway, AR 72034
Phone (501) 329-1510

Interoperability endpoints

  • Direct secure messaging: emily.mckinney@1246.chartlogic.direct-ci.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1720620818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CLUB LN",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343681",
            "telephone_number": "501-329-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CLUB LN",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343681",
            "telephone_number": "501-329-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "EMILY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "HARRIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.