Active NPI
Carrie L McKinney, RD
- Registered Dietitian
- Danville, IL
National Provider Identifier
1790983823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 812 N Logan Ave
Logan Campus
Danville, IL 61832-3752 - Phone
- (215) 493-4025
- Fax
- (215) 493-8039
- NPI assigned
- Jul 10, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | IL | Primary |
Addresses
Primary practice location
812 N Logan Ave
Logan Campus
Danville, IL 61832-3752
Mailing address
3318 S Crooks Bridge Rd
Rockville, IN 47872-7072
Phone (765) 562-2997
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164004575 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sodexo Operations LLC | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1790983823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3318 S CROOKS BRIDGE RD",
"city": "ROCKVILLE",
"state": "IN",
"postal_code": "478727072",
"telephone_number": "765-562-2997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 N LOGAN AVE",
"address_2": "LOGAN CAMPUS",
"city": "DANVILLE",
"state": "IL",
"postal_code": "618323752",
"telephone_number": "215-493-4025",
"fax_number": "215-493-8039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNEY",
"first_name": "CARRIE",
"middle_name": "L",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.