Elyssa Marie McKinney, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

03223 Issued in KY

Practice address

640 Wright Ave
Bowling Green, KY 42103-1623

Phone

(859) 605-6480

NPI assigned

May 28, 2008

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1992963862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 WRIGHT AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421031623",
            "telephone_number": "859-605-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 WRIGHT AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421031623",
            "telephone_number": "859-605-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "ELYSSA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "03223",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9543",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reba McGinnis, M.ED., LPCC
• Laura Elizabeth McGranahan, CSW
• Maleigha McGrew
• Gary McGuffey, RPH
• Wade Michael McGuire, LPCC
• Heather N McKinney, BS, RBT
• Julia Sue McKinney
• Katelyn Brooke McKinney, BS, RBT
• Laura McKinney, RPH
• Sarah Elizabeth McMaine-Render

• General Practice Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.