NPIMap

Individual provider Active NPI

Joseph P McKenna, M.D.

  • Nephrology Physician
  • Muskegon, MI
National Provider Identifier
1760411599
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301090933 Issued in MI
Practice address
1250 Mercy Dr Ste 101
Muskegon, MI 49444-1881
Phone
(231) 733-1912
Fax
(231) 737-4603
NPI assigned
Jul 2, 2006
Last updated
May 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 016533 ME
Nephrology Physician 207RN0300X 4301090933 MI Primary

Addresses

Primary practice location

1250 Mercy Dr Ste 101
Muskegon, MI 49444-1881

Mailing address

1250 Mercy Dr Ste 101
Muskegon, MI 49444-1881
Phone (231) 733-1912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000759 MI Practitioner - Nephrology 0345200580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of New Mexico School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Nephrology PLLCGroup PAC ID 5395642953, 8 clinicians

Practice addresses (Care Compare)

1250 Mercy Dr
Suite 101
Muskegon, MI 49444-1881
Phone (231) 733-1912

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301090933MIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Nephrology PLLC Nephrology CurrentSince Aug 1, 2007 Accepting new patients

Locations

1250 Mercy Dr
Ste 101
Muskegon, MI 49444
Phone (231) 733-1912

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: joseph.mckenna@direct.davitaphysiciansolutions.com

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.

Hospital & facility affiliations 12

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1760411599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MERCY DR STE 101",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441881",
            "telephone_number": "231-733-1912",
            "fax_number": "231-737-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MERCY DR STE 101",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441881",
            "telephone_number": "231-733-1912",
            "fax_number": "231-737-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "016533",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301090933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.