Individual provider Active NPI

Mary Cathrine McKenzie, MOT/OTR, CPRCS

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1003091463
Registry record updated Mar 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
104479 Issued in TX
Practice address
7217 Hawkins View Dr Ste 201
Fort Worth, TX 76132-3928
Phone
(817) 479-7019
NPI assigned
Jan 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 104479 TX
Occupational Therapist 225X00000X 104479 TX Primary

Addresses

Primary practice location

7217 Hawkins View Dr Ste 201
Fort Worth, TX 76132-3928

Mailing address

7217 Hawkins View Dr Ste 201
Fort Worth, TX 76132-3928
Phone (812) 479-7019

Other identifiers 1

IdentifierTypeStateIssuer
084NTOtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104479TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monkey Mouths, PLLC Occupational Therapist PastSince Mar 5, 2023 Accepting new patients
McKenzie Pediatric Occupational Therapy PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1003091463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7217 HAWKINS VIEW DR STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323928",
            "telephone_number": "812-479-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 HAWKINS VIEW DR STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323928",
            "telephone_number": "817-479-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "MARY CATHRINE",
        "name_prefix": "Ms.",
        "credential": "MOT/OTR, CPRCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "104479",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "104479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "084NT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2023; 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.