Individual provider Active NPI

McKenzi Vinson, PT, DPT

  • Physical Therapist
  • Collierville, TN
National Provider Identifier
1164308243
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16617 Issued in TN
Practice address
930 W Poplar Ave Ste 5
Collierville, TN 38017-2583
Phone
(901) 316-5456
NPI assigned
Aug 13, 2025
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16617 TN Primary

Addresses

Primary practice location

930 W Poplar Ave Ste 5
Collierville, TN 38017-2583

Mailing address

930 W Poplar Ave Ste 5
Collierville, TN 38017-2583

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930002491 TN Practitioner - Physical Therapist in Private Practice 0345746228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Tennessee, HSC, College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

930 W Poplar Ave
Suite 5
Collierville, TN 38017-2583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16617TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Potential Physiotherapy and Wellness Physical Therapist CurrentSince Aug 15, 2025 Accepting new patients

Locations

930 W Poplar Ave
Ste 5
Collierville, TN 38017
Phone (901) 316-5456

1045 Oakhaven Rd
Memphis, TN 38119
Phone (901) 665-0500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1164308243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 W POPLAR AVE STE 5",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W POPLAR AVE STE 5",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172583",
            "telephone_number": "901-316-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "MCKENZI",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.