NPIMap

Individual provider Active NPI

Judith J McKenzie, MD

  • Family Medicine Physician
  • Newport News, VA
National Provider Identifier
1215902887
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101235243 Issued in VA
Practice address
11803 Jefferson Ave
Ste 100
Newport News, VA 23606
Phone
(757) 594-1870
Fax
(757) 594-1841
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101235243 VA Primary

Addresses

Primary practice location

11803 Jefferson Ave
Ste 100
Newport News, VA 23606

Mailing address

11803 Jefferson Ave
Ste 100
Newport News, VA 23606
Phone (757) 594-1870

Other identifiers 1

IdentifierTypeStateIssuer
010015162MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504001705 VA Practitioner - Internal Medicine 4284622549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Miami, LM Miller School of Medicine, 1993
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8580 Magellan Pkwy
Richmond, VA 23227-1149

Hospital & facility affiliations

  • Compassus BSMH Richmond HHA, LLC Home health agency, Richmond, VA, CCN 497026
  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112
  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours - Memorial Regional Medical Center, Inc. CurrentSince May 1, 2015 Accepting new patients
Bon Secours Medical Group Richmond Primary Care LLC Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC CurrentSince May 1, 2015 Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Current Accepting new patients
Bon Secours Memorial Regional Medical Center LLC Past Accepting new patients
Osler Medical Inc Past Accepting new patients

Locations

1041 Sharon Rd
Ste 205
King William, VA 23086
Phone (804) 746-1677

8200 Meadowbridge Rd
Ste 306
Mechanicsville, VA 23116
Phone (804) 764-1253

4630 S Laburnum Ave
Richmond, VA 23231
Phone (804) 226-2444

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215902887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 JEFFERSON AVE",
            "address_2": "STE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-594-1870",
            "fax_number": "757-594-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 JEFFERSON AVE",
            "address_2": "STE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-594-1870",
            "fax_number": "757-594-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JUDITH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101235243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010015162",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.