Mackenzie Stack, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

463721 State Road 200 Ste 7
Yulee, FL 32097-8661

Phone

(904) 602-6088

NPI assigned

Feb 11, 2020

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mackenzie Steddom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Therawest LLC

  dba TheraWest Physical Therapy

  • Physical Therapist
  • Clinton, OK
  • NPI 1700087079
  NPD
• Therawest LLC

  dba TheraWest Physical Therapy

  • Physical Therapist
  • Clinton, OK
  • NPI 1114142486
  NPD (past)

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1023640646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-345-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463721 STATE ROAD 200 STE 7",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320978661",
            "telephone_number": "904-602-6088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 First Coast Hwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320345598",
            "country_code": "US",
            "telephone_number": "904-321-5491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACK",
        "first_name": "MACKENZIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "STEDDOM",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsay Nicole Snyder
• Solantic of Jacksonville, LLC (CareSpot-Yulee)
• Somethings Medical PA (Somethings Medical-FL)
• Southern Baptist Hospital (Psychiatric and Psychological Care)
• Isismayy Hinojosa Spradley
• Chelsey Steffen
• Lee Anne Stephens, RN
• Victoria Faith Stephens
• Eric Stepnowski, DC
• Kathleen Stevens, DDS

• Physical Therapist in Yulee, FL
• Providers in Yulee, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; 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.