DR. ROGER E MCKINNEY (NPI# 1215995972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215995972 |
| Entity Type | Individual |
| Full Name | DR. ROGER E MCKINNEY |
| Credential | M.D. |
| Practice Address |
1407 W Baddour Pkwy Lebanon TN 37087-2513 |
| Practice Telephone | 6154446203 |
| Practice Fax Number | 6154446252 |
| Mailing Telephone | 6154446203 |
| Mailing Fax Number | 6154446252 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11814 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS | 3132332 | 01 |
| TN | CIGNA | 4066071 | 01 |
| TN | CAQH | 10809852 | 01 |
| TN | WORK COMP | 166465000 | 01 |
| TN | UHC | 244555 | 01 |
| TN | MEDICARE RR | 080157111 | 01 |
| TN | 3180880 | 05 | |
| TN | LICENSE | MD11814 | 01 |
| Street Address |
1407 W BADDOUR PKWY |
| City | LEBANON |
| State | TN |
| Zip Code | 37087-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487610069 | Erin Mcculloch Crisp | Physician Assistant | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2006-04-24 |
| 1518360874 | Lindsey Nicole Lattimore | Emergency Medical Technician, Intermediate | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2014-10-01 |
| 1417296807 | Christine Corpuz Kowal | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2013-02-05 |
| 1922359025 | John William Deason IIi | Pharmacist | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2012-09-28 |
| 1073742250 | Richard A. Kincaid | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2009-07-08 |
| 1629221692 | Tracy L Moss | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2008-11-03 |
| 1629245634 | Benita K Qualls | Physician Assistant | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2008-05-09 |
| 1306013305 | Jason L Black | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2008-05-09 |
| 1083881064 | Jaime Christen Blaylock | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2008-05-09 |
| 1255526380 | Keith T Winfree | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2007-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051698 | Results-ast Jv, LLC | Physical Therapist | 1420 West Baddour Parkway, Suite 102, Lebanon, TN 37087 | 2020-10-19 |
| 1306405725 | Angela Kurtz | Hearing Instrument Specialist | 1430 West Baddour Parkwayste D, Lebanon, TN 37087 | 2019-06-10 |
| 1164926937 | Andrea Christine Morrisett | Physical Therapist | 404 N Castle Heights Ave Ste G, Lebanon, TN 37087 | 2018-03-19 |
| 1942731492 | Rocky Mountain Holdings, LLC | Ambulance | 760d Franklin Rd, Lebanon, TN 37087 | 2017-03-27 |
| 1326409285 | Karina Lawrence | Speech-Language Pathologist | 1006 Keaton Street, Lebanon, TN 37087 | 2016-03-18 |
| 1174910491 | Yehualashet Bekele Hailemariam | Internal Medicine | 1411 W Baddour Pkwy,lebanon Tn 37087, Lebanon, TN 37087 | 2015-04-24 |
| 1043614829 | Jean Thompson | Behavioral Analyst | 1004 Hickory Hill Lane, Suite 2, Hermitage, TN 37087 | 2014-10-22 |
| 1588072771 | La Keisha Fair | Community Health Worker | 1 Cumberland Square, Lebanon, TN 37087 | 2014-07-31 |
| 1023440609 | James Martin Meadows | Specialist/Technologist | One Cumberland Square, Lebanon, TN 37087 | 2013-08-06 |
| 1336571231 | Lori Ann De Leo | Social Worker | 109 Autumn Creek, Lebanon, TN 37087 | 2013-08-01 |
| Find all providers in zip 37087 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1033693031 | Heather Heck | Family Medicine | 1701 Cornwal Road, Lebanon, PA 17042-7480 | 2018-09-17 |
| 1982113148 | A1 Health Care Clinic | Family Medicine | 703 East Main Street, # 8, Lebanon, KY 40444 | 2017-09-20 |
| 1952830127 | Juliana Zamora Cubillos | Family Medicine | 120 Hospital Dr Ste 100, Lebanon, MO 65536-9227 | 2017-06-09 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1982080255 | Dawn Barker | Family Medicine | 331 Hospital Dr Ste C, Lebanon, MO 65536 | 2015-08-10 |
| 1467848952 | Kelly Renee Deatley | Family Medicine | 325 W Walnut St Ste 600, Lebanon, KY 40033 | 2015-04-10 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1407288210 | Healthsource of Ohio, Inc. | Family Medicine | 1231 Columbus Ave, Unit A 1, Lebanon, OH 45036-8195 | 2013-08-02 |
| 1598108763 | Docare,llc | Family Medicine | 680 E Grant St, Lebanon, OR 97355-4432 | 2013-04-08 |
| Find all providers in LEBANON | ||||
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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.