Individual provider Active NPI

Kaylee McKinnon

  • Pharmacist
  • Erie, PA
National Provider Identifier
1760070288
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP452705 Issued in PA
Practice address
3750 Sterrettania Rd
Erie, PA 16506-2829
Phone
(814) 835-4984
NPI assigned
Jan 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP452705 PA Primary
Pharmacist 183500000X 03132332 OH

Addresses

Primary practice location

3750 Sterrettania Rd
Erie, PA 16506-2829

Mailing address

2807 Sienna TRL
Waterford, PA 16441-5508

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03132332OHMDPharmacist
RP452705PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania CVS Pharmacy, L.L.C. PastSince Jan 17, 2021 Accepting new patients
Pennsylvania CVS Pharmacy, L.L.C PastSince Jan 17, 2021 Accepting new patients

Organizations & group practices 2

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": "1610236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1760070288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 SIENNA TRL",
            "city": "WATERFORD",
            "state": "PA",
            "postal_code": "164415508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 STERRETTANIA RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062829",
            "telephone_number": "814-835-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "KAYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-10",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP452705",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03132332",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.