Individual provider Active NPI

Lynda M McKinnon, MD CM

  • Family Medicine Physician
  • Anderson, SC
National Provider Identifier
1922110956
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18284 Issued in SC
Practice address
2001 E Greenville St
Anderson, SC 29621-1529
Phone
(864) 332-3098
Fax
(855) 232-3959
NPI assigned
Aug 31, 2006
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18284 SC Primary

Addresses

Primary practice location

2001 E Greenville St
Anderson, SC 29621-1529

Mailing address

2001 E Greenville St
Anderson, SC 29621-1529
Phone (864) 332-3098

Other identifiers 2

IdentifierTypeStateIssuer
18284OtherSCMEDICAL LICENSES
182849MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lynda.mckinnon@centerwell.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061220000101 SC Practitioner - Family PracticePractitioner - General Practice 5092714014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18284SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (SC) PC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Centerwell Senior Primary Care (SC) PC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Med Central Health Resources, Inc PastSince Nov 21, 2016 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

6416 Old Winter Garden Rd
Orlando, FL 32835
Phone (407) 281-1755

108 Highway 28 Byp
Anderson, SC 29624
Phone (864) 296-5208

2001 E Greenville St
Anderson, SC 29621
Phone (864) 332-3098

Interoperability endpoints

  • Direct secure messaging: lynda.mckinnon@centerwell.eclinicaldirectplus.com

Organizations & group practices 3

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.

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": "1637625600000",
    "number": "1922110956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211529",
            "telephone_number": "864-332-3098",
            "fax_number": "855-232-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211529",
            "telephone_number": "864-332-3098",
            "fax_number": "855-232-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "LYNDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD CM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSES",
            "identifier": "18284",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182849",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lynda.mckinnon@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2001 E Greenville St",
            "city": "Anderson",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296211529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.