Individual provider Active NPI

Bethel L McKenzie

  • Clinical Social Worker
  • Anderson, IN
National Provider Identifier
1033627427
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34008191A Issued in IN
Practice address
2210 Jackson St
Anderson, IN 46016-4363
Phone
(765) 683-3118
NPI assigned
Jan 19, 2018
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008191A IN Primary

Addresses

Primary practice location

2210 Jackson St
Anderson, IN 46016-4363

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Other practice location 1

100 N Tillotson Ave
Muncie, IN 47304
Phone (765) 288-8770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710001006 IN Practitioner - Clinical Social Worker 6103172903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2210 Jackson St
Anderson, IN 46016-4363
Phone (765) 644-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Anderson Regional Hospital, Inc. CurrentSince Mar 3, 2025 Accepting new patients
St. Vincent Anderson Regional Hospital, Inc. CurrentSince Mar 3, 2025 Accepting new patients

Locations

2210 Jackson St
Anderson, IN 46016
Phone (765) 644-1414

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

Interoperability endpoints

  • Direct secure messaging: bethel.mckenzie.1@7598.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1033627427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164363",
            "telephone_number": "765-683-3118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Tillotson Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "47304",
            "country_code": "US",
            "telephone_number": "765-288-8770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "BETHEL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008191A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.