Individual provider Active NPI

Mackenzie Elizabeth Nelson, MD

  • General Practice Physician
  • Bethesda, MD
National Provider Identifier
1023765138
Registry record updated Dec 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101279917 Issued in VA
Practice address
8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone
(301) 400-2838
NPI assigned
Mar 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101279917 VA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Bethesda, MD 20889-0004

Mailing address

8901 Wisconsin Ave
Bethesda, MD 20889-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221004050 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6002266699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101279917VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702771200000",
    "number": "1023765138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-400-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MACKENZIE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101279917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.