Active NPI
Lacey Aileen McKenzie, CNP
- Family Medicine Physician
- Springboro, OH
National Provider Identifier
1124676762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- APRN.CNP.022989
- Practice address
- 540 W Central Ave
Springboro, OH 45066-1110 - Phone
- (937) 550-4511
- NPI assigned
- Aug 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | APRN.CNP.022989 | OH | Primary |
Addresses
Primary practice location
540 W Central Ave
Springboro, OH 45066-1110
Mailing address
540 W Central Ave
Springboro, OH 45066-1110
Phone (740) 361-5267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566864000000",
"number": "1124676762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 W CENTRAL AVE",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450661110",
"telephone_number": "740-361-5267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 W CENTRAL AVE",
"city": "SPRINGBORO",
"state": "OH",
"postal_code": "450661110",
"telephone_number": "937-550-4511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "LACEY",
"middle_name": "AILEEN",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2019-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "APRN.CNP.022989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springboro, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.