Individual provider Active NPI

Maureen Kay McKindles, RN

  • Registered Nurse
  • Iron Mountain, MI
National Provider Identifier
1780904177
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
78303030 Issued in WI
Practice address
N3400 Four Seasons Dr
Iron Mountain, MI 49801-9465
Phone
(906) 776-1809
NPI assigned
Jun 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 78303030 WI Primary
Registered Nurse 163W00000X 4704128539 MI
General Practice Registered Nurse 163WG0000X 4704128539 MI
General Practice Registered Nurse 163WG0000X 78303030 WI
Home Health Registered Nurse 163WH0200X 4704128539 MI
Home Health Registered Nurse 163WH0200X 78303030 WI
Pediatric Registered Nurse 163WP0200X 4704128539 MI
Pediatric Registered Nurse 163WP0200X 78303030 WI
School Registered Nurse 163WS0200X 4704128539 MI
School Registered Nurse 163WS0200X 78303030 WI

Addresses

Primary practice location

N3400 Four Seasons Dr
Iron Mountain, MI 49801-9465

Mailing address

N3400 Four Seasons Dr
Iron Mountain, MI 49801-9465
Phone (906) 776-1809

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704128539MIMDPediatric Registered Nurse
78303030WIMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1780904177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3400 FOUR SEASONS DR",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498019465",
            "telephone_number": "906-776-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3400 FOUR SEASONS DR",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498019465",
            "telephone_number": "906-776-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINDLES",
        "first_name": "MAUREEN",
        "middle_name": "KAY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "78303030",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704128539",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704128539",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "WI",
            "license": "78303030",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MI",
            "license": "4704128539",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "78303030",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MI",
            "license": "4704128539",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "WI",
            "license": "78303030",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "MI",
            "license": "4704128539",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WI",
            "license": "78303030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.