Kenneth E McKenzie, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03879R Issued in LA

Practice address

5008 W 92ND Ave
Westminster, CO 80031-6302

Phone

(318) 412-7035

Fax

(318) 412-7993

NPI assigned

Aug 19, 2006

Last updated

Nov 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Premier Physical Therapy, LLC

  • Physical Therapist
  • Westminster, CO
  • NPI 1407249774
  Medicare reassignment NPD
• Premier Physical Therapy

  • Physical Therapist
  • Westminster, CO
  • NPI 1790223477
  NPD (past)
• Clark Integrated Medical Clinics LLC

  dba Clark Integrated Medical Clinics

  • General Practice Physician
  • Lafayette, LA
  • NPI 1124529284
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1114032570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800316302",
            "telephone_number": "318-412-7035",
            "fax_number": "318-412-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800316302",
            "telephone_number": "318-412-7035",
            "fax_number": "318-412-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "KENNETH",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "03879R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1475955",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua McGee
• Shyla Lee McGeeney
• Morgan E McGraw
• Timothy David McKay, PHARMD
• Eavan McKenzie, MFTC
• Paul D McKeon, DPT
• Dylan McKnight, DMD
• Gina McMahan
• Lamont G. McMurtrey, D.D.S., M.S.
• Lonnie L McMurtrey, DDS

• Physical Therapist in Westminster, CO
• Providers in Westminster, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.