Jennifer Louise McKenzie, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2012014779 Issued in MO

Practice address

19550 E 39TH St S Ste 110
Independence, MO 64057-2353

Phone

(816) 698-8900

Fax

(816) 698-8905

NPI assigned

Apr 16, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Midwest Doctors Group, LLC

  dba Mid-America Sports Medicine and Wellness

  • Sports Medicine (Family Medicine) Physician
  • Independence, MO
  • NPI 1841462314
  NPD (past)

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1205193240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 STATE LINE RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641114423",
            "telephone_number": "816-908-9739",
            "fax_number": "816-908-9738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 110",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572353",
            "telephone_number": "816-698-8900",
            "fax_number": "816-698-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012014779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Sanford McIntosh, M.D.
• Brittany Erin McIntyre, PA-C
• Forrestal McKay, PLCSW
• Steven A McKay, OD
• Margie McKee, LPC
• Eric James McKinnon
• Alena McLoughlin
• Elizabeth McManamy, RPH
• Kylie McMullen
• Crystal McNack, RN

• Family Nurse Practitioner in Independence, MO
• Providers in Independence, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.