Shelley McKenzie, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

M8088 Issued in MS

Practice address

1305 Gill St
Columbia, MS 39429-2605

Phone

(601) 705-1901

NPI assigned

Aug 14, 2009

Last updated

Aug 14, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Region 12 Commission on Mental Health and Retardation Pine Belt MenGroup PAC ID 3971561747, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Region 12 Commission on Mental Health & Retardation Pine Belt Men

  dba Pine Belt Mental Health Care Resources

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hattiesburg, MS
  • NPI 1982610572
  Medicare reassignment Care Compare group NPD
• Region XII Commission

  • General Practice Physician
  • Laurel, MS
  • NPI 1467767988
  NPD

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1144452822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 GILL ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292605",
            "telephone_number": "601-705-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 GILL ST",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394292605",
            "telephone_number": "601-705-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "SHELLEY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "M8088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daryn Michael McArthur, LPTA
• Bryan F McCraw, M.D.
• Joshua McDade, CAT
• Jessica Amanda McKenzie, FNP
• Lala McKenzie, IDD WAIVER SERVICES
• Susan Lorenda McLendon, LPN
• Med360 LLC (Med360)
• Larry Ethan Milton, DPM
• Janet Mingo
• Mississippi Pharmaceutical Services, LLC (Columbia Medical Supply)

• Clinical Social Worker in Columbia, MS
• Providers in Columbia, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.