Individual provider Active NPI

Adam Nathaniel McKinney, CAA

  • Anesthesiologist Assistant
  • Fort Wayne, IN
National Provider Identifier
1891340030
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
75000109A Issued in IN
Practice address
6435 W Jefferson Blvd # 434
Fort Wayne, IN 46804-6203
Phone
(260) 436-7875
Fax
(260) 432-9812
NPI assigned
Aug 5, 2019
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 75000109A IN Primary

Addresses

Primary practice location

6435 W Jefferson Blvd # 434
Fort Wayne, IN 46804-6203

Mailing address

PO Box 843603
Dallas, TX 75284-0001
Phone (972) 233-1999

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191127000884 GA Practitioner - Anesthesiology Assistant 4880027101 Reassigns benefits to 2 organizations
I20230512000670 IN Practitioner - Anesthesiology Assistant 4880027101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Anesthesiologists of Fort Wayne PCGroup PAC ID 2264412444, 101 clinicians

Practice addresses (Care Compare)

4023 Reas LN
New Albany, IN 47150-2228
Phone (812) 206-7660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Indiana LLC CurrentSince Apr 10, 2023 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Nov 1, 2021 Accepting new patients
One Anesthesia PLLC CurrentSince Jan 28, 2023 Accepting new patients
Associated Anesthesiologists of Fort Wayne PC Anesthesiologist Assistant CurrentSince Mar 11, 2025 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Oct 1, 2019 Accepting new patients
U S Anesthesia Partners of Kentucky PSC Anesthesiologist Assistant PastSince Jul 1, 2023 Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1316 E 7th St
Auburn, IN 46706
Phone (260) 925-4600

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

6435 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 436-7875

1220 Missouri Ave
Rm 2547
Jeffersonville, IN 47130

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

4023 Reas Ln
New Albany, IN 47150
Phone (502) 489-4325

320 Whittington Pkwy
Ste 301
Louisville, KY 40222
Phone (502) 625-5584

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1891340030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843603",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840001",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 W JEFFERSON BLVD # 434",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046203",
            "telephone_number": "260-436-7875",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "ADAM",
        "middle_name": "NATHANIEL",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "IN",
            "license": "75000109A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.