Wayne Mackenzie Sr., NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP4913 Issued in AZ

Practice address

319 N Litchfield Rd Ste 105
Goodyear, AZ 85338-1256

Phone

(623) 224-1162

Fax

(888) 346-3899

NPI assigned

May 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Desert View Counseling and Consulting IncGroup PAC ID 4981644325, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Desert View Counseling and Consulting, Inc.

  • Mental Health Counselor
  • Peoria, AZ
  • NPI 1124173471

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1336867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1144589086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 N LITCHFIELD RD STE 105",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381256",
            "telephone_number": "623-224-1162",
            "fax_number": "888-346-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 N LITCHFIELD RD STE 105",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381256",
            "telephone_number": "623-224-1162",
            "fax_number": "888-346-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "WAYNE",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-13",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201250163NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP4913",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "707607",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QXIPQ0000098776",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "804045",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wayne@agapefamily.net",
            "affiliation": "N",
            "endpointDescription": "organizational E-Mail address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Text format emails only",
            "address_1": "319 N Litchfield Rd Ste 105",
            "city": "Goodyear",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853381256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia A. Lynch, M.D.
• Stephen F Lynch, M.D.
• M&M Sunrise Behavioral Home, LLC
• Brett Yifei Ma, D.M.D
• Zaira Macias, PT, DPT
• Sean Mackey, DO
• Daniel T. Macleod, DO
• Maria Theresa Jalandoni Magat, AGPCNP-BC
• Stephen Magno Doronila Magat, MSN-NP
• Carlie Nicole Magers

• Psychiatric/Mental Health Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.