Individual provider Active NPI

Bernice M McKenzie

  • Driver
  • Moncks Corner, SC
National Provider Identifier
1134095193
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
003451562 Issued in SC
Practice address
1220 Saint Johns Ave
Moncks Corner, SC 29461-9265
Phone
(843) 437-6598
NPI assigned
Oct 15, 2025
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 003451562 SC Primary

Addresses

Primary practice location

1220 Saint Johns Ave
Moncks Corner, SC 29461-9265

Mailing address

1220 Saint Johns Ave
Moncks Corner, SC 29461-9265
Phone (843) 437-6598

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003451562SCMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1134095193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SAINT JOHNS AVE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294619265",
            "telephone_number": "843-437-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SAINT JOHNS AVE",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294619265",
            "telephone_number": "843-437-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "BERNICE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "SC",
            "license": "003451562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.