Active NPI
Debra S McKay, PA-C
- Physician Assistant
- Aberdeen, ID
National Provider Identifier
1730161399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA667
- Practice address
- 306 N Main
Aberdeen, ID 83210 - Phone
- (208) 397-4126
- Fax
- (208) 397-4176
- NPI assigned
- Nov 18, 2005
- Last updated
- Apr 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA667 | ID | Primary |
| Medical Physician Assistant | 363AM0700X | PA012379 | TX |
Addresses
Primary practice location
306 N Main
Aberdeen, ID 83210
Mailing address
PO Box 2377
Pocatello, ID 83206-2377
Phone (208) 232-7862
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010160947 | Other | ID | BLUE SHIELD-DOWNEY |
| 000010160950 | Other | ID | BLUE SHIELD-POCATELLO |
| PAF31 | Other | ID | BLUE CROSS-AMERICAN FALLS |
| PAF30 | Other | ID | BLUE CROSS-ABERDEEN |
| PAF32 | Other | ID | BLUE CROSS-DOWNEY |
| PAF35 | Other | ID | BLUE CROSS-POCATELLO |
| 000010160946 | Other | ID | BLUE SHIELD-ABERDEEN |
| 000010160945 | Other | ID | BLUE SHIELD-AMERICAN FALL |
| 000010160949 | Other | ID | BLUE SHIELD-MCCAMMON |
| PAF33 | Other | ID | BLUE CROSS-LAVA |
| PAF34 | Other | ID | BLUE CROSS-MCCAMMON |
| 000010160948 | Other | ID | BLUE SHIELD-LAVA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA667 | ID | MD | Physician Assistant |
| PA012379 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health West, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sryinga Elementary School
- Federally Qualified Health Center (FQHC)
- Pocatello, ID
- NPI 1740143882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1730161399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2377",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832062377",
"telephone_number": "208-232-7862",
"fax_number": "208-232-7869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 N MAIN",
"city": "ABERDEEN",
"state": "ID",
"postal_code": "83210",
"telephone_number": "208-397-4126",
"fax_number": "208-397-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKAY",
"first_name": "DEBRA",
"middle_name": "S",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA667",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA012379",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD-DOWNEY",
"identifier": "000010160947",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD-POCATELLO",
"identifier": "000010160950",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-AMERICAN FALLS",
"identifier": "PAF31",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-ABERDEEN",
"identifier": "PAF30",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-DOWNEY",
"identifier": "PAF32",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-POCATELLO",
"identifier": "PAF35",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD-ABERDEEN",
"identifier": "000010160946",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD-AMERICAN FALL",
"identifier": "000010160945",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD-MCCAMMON",
"identifier": "000010160949",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-LAVA",
"identifier": "PAF33",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-MCCAMMON",
"identifier": "PAF34",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD-LAVA",
"identifier": "000010160948",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, ID
- County of Bingham School Dist Aberdeen Class a (Aberdeen School District #58)
- Driscoll Dental, PLLC
- Mitch Driscoll, DMD
- Natalie Fuss
- Health West, Inc. (Health West Aberdeen Clinic)
- Power County Hospital District (Aberdeen Family Clinic)
- Heather Ann Schaper, PA
- Brent Tracy Schvaneveldt, D.M.D.
- Nicole Shackelford, LMSW
- David William Vaughn
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.