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Deactivated NPI 1205932811 Deactivated / Inactive NPI Male Practitioner

Dr. Tim H. Mckinnon , OD

Optometrist • Deridder, LA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Tim Mckinnon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 15, 2006
NPI Deactivation Date January 13, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Tim Mckinnon, OD was a registered Optometrist practicing in Deridder, LA. Throughout an active medical career spanning 15 years, Dr. Mckinnon provided care at the practice location at 1125 N PINE ST until profile deactivation on 2021-01-13.

Practice Location & Contact Primary Location

Practice Address

1125 N Pine St

Deridder, LA 706342819

Telephone 3374622015
Fax 8775203047
Associated Practice Facility / Clinic
🏢 Wal-Mart Stores East Lp Facility NPI 1982621223

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Deridder, LA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 50.0 Yrs
State Avg: 22.5 Yrs
Regional Practice Density
3 Specialists

Practicing in Deridder, LA (571 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License LA 828-329T

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1154354215

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 13, 2021

Record deactivated on January 13, 2021

NPI Profile Active May 30, 2011

NPI status registered as active in NPPES database

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Updated Practice Location May 30, 2011

Registered at 1125 N PINE ST, DERIDDER, LA 706342819 (Tel: 3374622015)

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Updated Business Mailing Address May 30, 2011

Registered at PO BOX 481, KENTWOOD, LA 704440481

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Provider Name / Credentials Updated May 30, 2011

Recorded as TIM MCKINNON, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2011

Optometrist (License #828-329T in LA)

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Initial NPI Registration & Enumeration September 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205932811
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2006
Last Update: May 30, 2011
Deactivation Date: January 13, 2021

Mailing Address

Po Box 481

Kentwood, LA 704440481

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.