RANDALL WADE MCKENNA (NPI# 1063477552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063477552 |
| Entity Type | Individual |
| Full Name | RANDALL WADE MCKENNA |
| Credential | DO |
| Practice Address |
1713 S Fm 51 Suite 103 Decatur TX 76234 |
| Practice Telephone | 9406276976 |
| Practice Fax Number | 9406273491 |
| Mailing Telephone | 9406276976 |
| Mailing Fax Number | 9406273491 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2019-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | J0118 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBSTX | 89Z590 | 01 |
| TX | 131938605 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2800 E Highway 114 Ste 130, Trophy Club, TX 762625305 | 4699164435 | 9406879035 |
| Street Address |
1713 S FM 51 SUITE 103 |
| City | DECATUR |
| State | TX |
| Zip Code | 76234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578568754 | Teresa N. Hill, M.d., P.a. | Obstetrics & Gynecology | 1713 S Fm 51, Suite 201, Decatur, TX 76234-3642 | 2005-06-15 |
| 1811318330 | North Central Texas Foot & Ankle, LLC | Podiatrist | 1713 S Fm 51, Suite 103, Decatur, TX 76234-3642 | 2013-12-31 |
| 1609154921 | Mckenna Orthopaedic and Sports Medicine Pa | Orthopaedic Surgery | 1713 S Fm 51, #103, Decatur, TX 76234-3642 | 2011-08-03 |
| 1710271325 | Troy Chandler P.a., P.C. | Physician Assistant | 1713 S Fm 51, #103, Decatur, TX 76234-3642 | 2011-06-01 |
| 1083922710 | North Central Texas Podiatry, Pa | Podiatrist | 1713 S Fm 51, 103, Decatur, TX 76234-3642 | 2010-09-15 |
| 1417264946 | Cbh Physical Medicine & Rehabilitation, P.a. | Physical Medicine & Rehabilitation | 1713 S Fm 51, 103, Decatur, TX 76234-3642 | 2010-09-03 |
| 1669530267 | Kevin Bernard James | Orthopaedic Surgery | 1713 S Fm 51, Suite #103, Decatur, TX 76234-3642 | 2006-12-05 |
| 1053402412 | Ryan K. Walter, Md, Pa | Obstetrics & Gynecology | 1713 S Fm 51, 201, Decatur, TX 76234 | 2006-09-28 |
| 1396855458 | Ricky L. Childers | Podiatrist | 1713 S Fm 51, Decatur, TX 76234-3642 | 2006-08-30 |
| 1568417087 | Dallas Vamc | Clinic/Center | 1713 S Fm 51, Decatur, TX 76234-3642 | 2006-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1689964280 | Saif U Zaman | Orthopaedic Surgery | 505 Irvin Ct Ste 200, Decatur, GA 30030-1780 | 2011-04-15 |
| 1740485317 | Georgia Knee & Sports Medicine | Orthopaedic Surgery | 2801 N Decatur Road, Decatur, GA 30033-5949 | 2007-06-15 |
| 1063553741 | Sportsmed Orthopaedic Specialists, P.C. | Orthopaedic Surgery | 2506 Danville Rd Sw Ste 202, Decatur, AL 35603-4232 | 2007-02-08 |
| 1336109867 | Orthopaedics Northeast, PC | Orthopaedic Surgery | 805 High St, Decatur, IN 46733-2324 | 2006-03-27 |
| 1245205020 | Julio Petilon | Orthopaedic Surgery | 2801 N Decatur Rd Ste 200, Decatur, GA 30033 | 2006-02-23 |
| 1437130986 | Fitzgerald Orthopaedics, P.C. | Orthopaedic Surgery | 203 N 12th St, Decatur, IN 46733-1554 | 2005-11-10 |
| 1891782918 | Lawrence A. Bircoll | Orthopaedic Surgery | 487 Winn Way, Suite 100, Decatur, GA 30030-1735 | 2005-10-04 |
| 1073500401 | James B. Madeley | Orthopaedic Surgery | 2680 Lawrenceville Hwy, Suite 100, Decatur, GA 30033-2526 | 2005-09-30 |
| 1811993405 | John C. Kefalas, M.d.,s.c. | Orthopaedic Surgery | 2905 N Main St, Suite G, Decatur, IL 62526-4276 | 2005-06-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.