Adita Graciela McKenzie, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP12493 Issued in CA

Practice address

12751 Harbor Blvd
Garden Grove, CA 92840-5800

Phone

(714) 620-8883

NPI assigned

Apr 23, 2007

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: amckenzie10348@altamed.direct-ci.com

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1124246129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12751 HARBOR BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405800",
            "telephone_number": "714-620-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12751 HARBOR BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405800",
            "telephone_number": "714-620-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ADITA",
        "middle_name": "GRACIELA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP12493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Paige McGee
• Jordan Elizabeth McGill
• Michael McGowan
• Drea McIver-Fiorica
• Vanity McKenzie Eselebor, PMHNP-BC
• Sharon Wong McKenzie, O.D.
• Paul D McKinley, D.O.
• MCL Gentle Care Home Health
• Nancy McLain, PT
• Bethany McMahon

• Family Nurse Practitioner in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.