Keith Vincent McInnerney, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA09502 Issued in TX

Practice address

630 N Kimball Ave Ste 100
Southlake, TX 76092-6886

Phone

(817) 421-8777

NPI assigned

Dec 12, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Better Faster LLCGroup PAC ID 9739304056, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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

• Better Faster, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southlake, TX
  • NPI 1770905788
  Medicare reassignment Care Compare group
• St. David'S Carenow Urgent Care PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1851844104
  NPD (past)

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1972901650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N KIMBALL AVE STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926886",
            "telephone_number": "817-421-8777",
            "fax_number": "817-421-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N KIMBALL AVE STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926886",
            "telephone_number": "817-421-8777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "908 N Rockford Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Ardmore",
            "state": "OK",
            "postal_code": "734012540",
            "country_code": "US",
            "telephone_number": "580-226-7771",
            "fax_number": "580-226-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINNERNEY",
        "first_name": "KEITH",
        "middle_name": "VINCENT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-12",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2585",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn McDonald, P.A.
• Erin Jepson McGee, FNP
• Kaitlyn Olivia McGee, M.S., CCC-SLP
• Katherine McGee
• Amanda McGukin, SLP
• Jennifer McIntosh, FNP
• Michelle M McKane, MD
• Michele Celeste McKean, MS, APRN, FNP-C
• Katarina Victoria McKinney
• Isabel Marie McKinsey

• Medical Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.