Wayland Wilson McKenzie, M.D.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

19760 Issued in NC

Practice address

500 A Banner Ave
Greensboro, NC 27401-3284

Phone

(336) 273-8638

Fax

(336) 274-0146

NPI assigned

Feb 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1235273509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 A BANNER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274013284",
            "telephone_number": "336-273-8638",
            "fax_number": "336-274-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 A BANNER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274013284",
            "telephone_number": "336-273-8638",
            "fax_number": "336-274-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "WAYLAND",
        "middle_name": "WILSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "19760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8957131",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Burt McKenzie Jr., M.D.
• Kayla J McKenzie, PA-C
• Patrick Lee McKenzie, MD
• Sarah McKenzie
• Shakia Forbes McKenzie
• William M. McKenzie, M.D.
• Justin McKinlay, D.D.S.
• Dominic W McKinley, MD
• Parish Ann McKinney, MD
• Richard Steven McKinney, RPH

• Primary Care Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.