Active NPI
Gene C. McKinley, LAT, ATC
- Athletic Trainer
- Bridge City, TX
National Provider Identifier
1770869299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0611
- Practice address
- 350 Bower Dr
Bridge City, TX 77611-2924 - Phone
- (409) 735-1642
- Fax
- (409) 735-1638
- NPI assigned
- Oct 28, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0611 | TX | Primary |
Addresses
Primary practice location
350 Bower Dr
Bridge City, TX 77611-2924
Mailing address
350 Bower Dr
Bridge City, TX 77611-2924
Phone (409) 735-1642
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT0611 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1770869299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 BOWER DR",
"city": "BRIDGE CITY",
"state": "TX",
"postal_code": "776112924",
"telephone_number": "409-735-1642",
"fax_number": "409-735-1638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 BOWER DR",
"city": "BRIDGE CITY",
"state": "TX",
"postal_code": "776112924",
"telephone_number": "409-735-1642",
"fax_number": "409-735-1638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINLEY",
"first_name": "GENE",
"middle_name": "C.",
"credential": "LAT, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-28",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "AT0611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridge City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.