Individual provider Active NPI

Makenzie Ann McKernan, WHNP

  • Nurse Practitioner
  • Malone, NY
National Provider Identifier
1144947904
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
421700 Issued in NY
Practice address
16 Third Street Uvmhn Alice Hyde Medical Center OB/GYN
Suite C
Malone, NY 12953
Phone
(518) 481-2896
Fax
(518) 481-2895
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 026.0142363 VT
Nurse Practitioner 363L00000X 421700 NY Primary

Addresses

Primary practice location

16 Third Street Uvmhn Alice Hyde Medical Center OB/GYN
Suite C
Malone, NY 12953

Mailing address

16 Third Street Ahmc OB/GYN & Midwifery
Suite C
Malone, NY 12953
Phone (518) 481-2896

Other practice location 1

108 Juniper Ln Apt 1
Middlebury, VT 05753-8892
Phone (151) 894-4706

Other names 1

  • Ms. Makenzie Ann Winslow Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20231130003604 NY Practitioner - Nurse Practitioner 2668820622 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
026.0142363VTMDRegistered Nurse
421700NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Current Accepting new patients
Alice Hyde Medical Center Nurse Practitioner CurrentSince Nov 1, 2023 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

16 3rd St
Ste C
Malone, NY 12953
Phone (518) 481-2896

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

Interoperability endpoints

  • Direct secure messaging: mwinslow378277@direct.uvmhealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1144947904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 THIRD STREET AHMC OB/GYN & MIDWIFERY",
            "address_2": "SUITE C",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "12953",
            "telephone_number": "518-481-2896",
            "fax_number": "518-481-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 THIRD STREET UVMHN ALICE HYDE MEDICAL CENTER OB/GYN",
            "address_2": "SUITE C",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "12953",
            "telephone_number": "518-481-2896",
            "fax_number": "518-481-2895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Juniper Ln Apt 1",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "VT",
            "postal_code": "057538892",
            "country_code": "US",
            "telephone_number": "151-894-4706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "MAKENZIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-12-20",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VT",
            "license": "026.0142363",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "421700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAKENZIE",
            "last_name": "WINSLOW",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "WHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.