Samuel McKenzie, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10982541-4405 Issued in UT

Practice address

6076 S 900 E Ste 102
Murray, UT 84121-1762

Phone

(801) 347-9223

NPI assigned

Jul 11, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samuel Hogan Former name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altium Health LLCGroup PAC ID 8729495692, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Altium Health LLC

  • Substance Abuse Rehabilitation Facility
  • West Jordan, UT
  • NPI 1235787870
  Medicare reassignment Care Compare group NPD
• Clearview Counseling & Assessment Inc

  • Mental Health Counselor
  • Sandy, UT
  • NPI 1881113314
  Medicare reassignment NPD

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1013695741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6076 S 900 E STE 102",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211762",
            "telephone_number": "801-347-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6076 S 900 E STE 102",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211762",
            "telephone_number": "801-347-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "SAMUEL",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "10982541-8900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "10982541-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "HOGAN",
            "credential": "APRN, PMHNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Bartholomew McKean, M.D.
• Kathleen E McKee, MD
• Morgan Shelton McKee, PA-C
• James Douglas McKell, OD
• Angela McKellar, M.D.
• Courtney McKinney, PHARMD
• Sarah R McLaren
• Michael J McLaughlin, MD
• Logan Arron McLean, MD
• Anna McMaster, SLP

• Psychiatric/Mental Health Nurse Practitioner in Murray, UT
• Providers in Murray, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.