Mona Melody McKenzie, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

002165 Issued in NY

Practice address

12929 133Rd St
South Ozone Park, NY 11420-3401

Phone

(646) 894-7879

NPI assigned

Apr 17, 2019

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1114580925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12929 133RD ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203401",
            "telephone_number": "646-894-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12929 133RD ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203401",
            "telephone_number": "646-894-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "MONA",
        "middle_name": "MELODY",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernadette L Mayers, NP
• Annmarie McDonald, MD
• Janis Irene McDonald, MA CCC-SLP
• Nicole McEwen
• Rawle Anthony McIntosh
• Catherine Mary McManus
• Levinia Melaram
• Mildred Mendez Monges, MSED
• Carroll Ann Mendonca, PT
• Regina Milerson, LMSW

• Athletic Trainer in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.