Individual provider Active NPI

Mackenzie Darr, NP

  • Family Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1013808401
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025003036 Issued in MI
Practice address
1355 Bogue St
East Lansing, MI 48824-6207
Phone
(800) 605-6424
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025003036 MI Primary

Addresses

Primary practice location

1355 Bogue St
East Lansing, MI 48824-6207

Mailing address

1355 Bogue St
East Lansing, MI 48824-6207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20251107001649 FL Practitioner - Nurse Practitioner 8628568698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Woodbridge Ctr Dr
Suite 425
Woodbridge, NJ 07095-1170

2389 E Venice Ave
Unit 510
Venice, FL 34292-2465

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025003036MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rejuva Dermatology & Vein Center, PLLC CurrentSince Oct 9, 2025 Accepting new patients

Locations

2389 E Venice Ave
Venice, FL 34292

395 Commercial Ct
Ste C
Venice, FL 34292
Phone (941) 529-0070

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1013808401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 BOGUE ST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488246207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 BOGUE ST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488246207",
            "telephone_number": "800-605-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARR",
        "first_name": "MACKENZIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "2025003036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.