Individual provider Active NPI

Mark Kelly McKain, MD

  • Surgery Physician
  • Twin Falls, ID
National Provider Identifier
1801907324
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M6053 Issued in ID
Practice address
253 Martin Street
Twin Falls, ID 83301-4532
Phone
(208) 733-0482
Fax
(208) 734-0263
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M6053 ID Primary

Addresses

Primary practice location

253 Martin Street
Twin Falls, ID 83301-4532

Mailing address

253 Martin Street
Twin Falls, ID 83301-4532
Phone (208) 733-0482

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M6053IDMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801907324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 MARTIN STREET",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014532",
            "telephone_number": "208-733-0482",
            "fax_number": "208-734-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 MARTIN STREET",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014532",
            "telephone_number": "208-733-0482",
            "fax_number": "208-734-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAIN",
        "first_name": "MARK",
        "middle_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M6053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

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

Verify at the official NPI Registry.