Keith A McKinniss, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

03-1-24661 Issued in OH

Practice address

30381 Chieftain Dr
Logan, OH 43138-9092

Phone

(740) 385-3120

NPI assigned

Sep 1, 2005

Last updated

May 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1780678060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30381 CHIEFTAIN DR",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389092",
            "telephone_number": "740-385-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30381 CHIEFTAIN DR",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389092",
            "telephone_number": "740-385-3120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Burlington Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "OH",
            "postal_code": "456409360",
            "country_code": "US",
            "telephone_number": "740-395-8364",
            "fax_number": "740-395-8372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNISS",
        "first_name": "KEITH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03124661",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-1-24661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha McCloud
• Mackenzie McClure
• Kevin McCoy, QMHS3
• Patricia L McGrath, CDCA
• Angela McKee, LPN
• Tyler McManaway
• Margaret Ann McMasters, LPN
• Kristy McQuaid
• Mary Meade, LPN
• Madison Mehall

• Pharmacist in Logan, OH
• Providers in Logan, OH by specialty
• Pharmacist in Ohio

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