Individual provider Active NPI

Makenzie Harman Mathers, FNP-C

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1104630227
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024192494 Issued in VA
Practice address
1024 First Colonial Rd
Virginia Beach, VA 23454-3074
Phone
(757) 395-2500
NPI assigned
Feb 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24192494 VA
Family Nurse Practitioner 363LF0000X 0024192494 VA Primary

Addresses

Primary practice location

1024 First Colonial Rd
Virginia Beach, VA 23454-3074

Mailing address

1024 First Colonial Rd Ste 102
Virginia Beach, VA 23454-3074
Phone (757) 395-2500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250606000607 VA Practitioner - Nurse Practitioner 7911417217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

1024 1St Colonial Rd
Virginia Beach, VA 23454-3074
Phone (757) 395-2500

Hospital & facility affiliations

  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24192494VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Family Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

824 N Military Hwy
Ste 100
Norfolk, VA 23502
Phone (888) 236-2263

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

1024 First Colonial Rd
Ste 102
Virginia Beach, VA 23454
Phone (757) 321-4030

1024 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2500

Interoperability endpoints

  • Direct secure messaging: mmathers465228@direct.sentara.net

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.

Hospital & facility affiliations 3

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": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1104630227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 FIRST COLONIAL RD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543074",
            "telephone_number": "757-395-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543074",
            "telephone_number": "757-395-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERS",
        "first_name": "MAKENZIE",
        "middle_name": "HARMAN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-07",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "24192494",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024192494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.