Active NPI
Robert Wesley McKinnie, MA LPCC
- Psychologist
- Santa Fe, NM
National Provider Identifier
1801955190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2969
- Practice address
- 3 Encantado Loop
Santa Fe, NM 87508 - Phone
- (505) 989-1313
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2969 | NM | Primary |
Addresses
Primary practice location
3 Encantado Loop
Santa Fe, NM 87508
Mailing address
3 Encantado Loop
Santa Fe, NM 87508
Phone (505) 989-1313
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM1101693 | Other | NM | VALUE OPTIONS |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2969 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801955190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 ENCANTADO LOOP",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87508",
"telephone_number": "505-989-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 ENCANTADO LOOP",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87508",
"telephone_number": "505-989-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNIE",
"first_name": "ROBERT",
"middle_name": "WESLEY",
"credential": "MA LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "2969",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "NM1101693",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
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.