Kathy M McKillop, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F380616-1 Issued in NY

Practice address

120 Mineola Blvd
Suite 210
Mineola, NY 11501-4073

Phone

(516) 663-4937

NPI assigned

Feb 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: kmckillop239044@nyumc.direct-ci.com

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1801937875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 LATHAM RD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012244",
            "telephone_number": "516-746-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 210",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLOP",
        "first_name": "KATHY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F380616-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmckillop239044@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "120 Mineola Blvd",
            "address_2": "suite 210",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115014073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robin McFee, DO
• Meghan McGath, MS
• Ian McGillivray
• Richard McGraw, DO
• Trevor James McHugh, MD
• Abigail Rose McNall, FNP
• John McNelis, MD
• Penelope A. McNicholas, RPA-C
• Colleen McQuade, RPAC
• Daniel McWeeney

• All providers in Mineola, NY
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.