M'Kenzee B Smith, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209-014864 Issued in IL

Practice address

1100 E Norris Dr
Ottawa, IL 61350-1604

Phone

(815) 433-1010

NPI assigned

Oct 17, 2016

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

Medicare fee-for-service enrollment

Enrolled in IL

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, PC

  • Hospitalist Physician
  • Ottawa, IL
  • NPI 1346480431
  Medicare reassignment NPD
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1073064952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501604",
            "telephone_number": "815-433-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E NORRIS DR",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613501604",
            "telephone_number": "815-433-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "M'KENZEE",
        "middle_name": "B",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-014864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sleep Better Inc (Ottawa Smiles)
• Small Hands Building Blocks, Inc.
• Smalltown Dental Ottawa PLLC
• Craig D Smith, OTR
• Danae Smith, APN
• Solid Rock Counseling
• Solid Source Healthcare Resources LLC (Solid Source Home Services)
• Solid Source Healthcare Resources LLC Home Services (Solid Source Healthcare Resources LLC)
• Southwest Dermatology
• Melissa Sporar, FNP-BC

• Nurse Practitioner in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.