Melissa a. McKinney, D.O., P.L.L.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

4057 Issued in AZ

Legal business name

MELISSA A. MCKINNEY, D.O., P.L.L.C.

Practice address

4283 Pima Way
Lake Montezuma, AZ 86342-5087

Phone

(928) 592-9140

Fax

(928) 592-9144

NPI assigned

Mar 10, 2008

Organization subpart

No

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

Authorized official

Name

Melissa A. McKinney, D.O.NPI 1124112123

Title

Physician

Phone

(928) 592-9140

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa A McKinney, D.O.

  • Family Medicine Physician
  • Honolulu, HI
  • NPI 1124112123
  NPD (past) Authorized official

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1932379658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 W HWY 89A #11 PMB 412",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365341",
            "telephone_number": "928-592-9140",
            "fax_number": "928-592-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4283 PIMA WAY",
            "city": "LAKE MONTEZUMA",
            "state": "AZ",
            "postal_code": "863425087",
            "telephone_number": "928-592-9140",
            "fax_number": "928-592-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA A. MCKINNEY, D.O., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "928-592-9140",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "4057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "Z104516",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan D Carter, DDS
• Copper Canyon Academy
• Montezuma Family Dental

• Primary Care Clinic/Center in Lake Montezuma, AZ
• Providers in Lake Montezuma, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.