McKenzie Renee Dolph, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2123 E 23Rd Ave S
Fremont, NE 68025-2498

Phone

(402) 721-1112

Fax

(402) 721-1113

NPI assigned

Jun 2, 2021

Last updated

Jun 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• McKenzie Renee Rusk Former name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Nebraska College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Key Physical Therapy, IncGroup PAC ID 5991988693, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Key Physical Therapy PC

  dba Key Complete Therapies

  • Physical Therapist
  • Omaha, NE
  • NPI 1710299169
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1164098869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 E 23RD AVE S",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252498",
            "telephone_number": "402-721-1112",
            "fax_number": "402-721-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 E 23RD AVE S",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252498",
            "telephone_number": "402-721-1112",
            "fax_number": "402-721-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLPH",
        "first_name": "MCKENZIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "RUSK",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Dobleman, MD
• Benjam Dobson
• Lauren Dobson, APRN
• Alyssa Dockerty
• Ashley Doherty, RN
• Darcy Jo Dorfmeyer
• Jeri Douglas
• Laura Dowty
• Dr. Ray Beach PC
• Lumir John Drahota, DDS

• Physical Therapist in Fremont, NE
• Providers in Fremont, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.