Individual provider Active NPI

Reginald B McKenzie, CPS-AD

  • Peer Specialist
  • Tucker, GA
National Provider Identifier
1235932633
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1957 Lakeside Pkwy Ste 510
Tucker, GA 30084-5859
Phone
(678) 289-0313
Fax
(404) 289-0314
NPI assigned
Mar 31, 2025
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X NU Primary

Addresses

Primary practice location

1957 Lakeside Pkwy Ste 510
Tucker, GA 30084-5859

Mailing address

PO Box 479
Avondale Estates, GA 30002-0479
Phone (404) 289-0313

Other practice location 1

4229 Snapfinger Woods Dr
Decatur, GA 30035-3440
Phone (404) 286-9252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Consultants of Atlanta, Inc. CurrentSince Apr 6, 2025 Accepting new patients
Recovery Consultants of Atlanta, Inc. PastSince Apr 6, 2025 Accepting new patients

Locations

4229 Snapfinger Woods Dr
Decatur, GA 30035
Phone (404) 286-9252

1957 Lakeside Pkwy
Ste 510
Tucker, GA 30084
Phone (404) 289-0313

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEGGAD

Organizations & group practices 2

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": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1235932633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300020479",
            "telephone_number": "404-289-0313",
            "fax_number": "404-289-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 LAKESIDE PKWY STE 510",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845859",
            "telephone_number": "678-289-0313",
            "fax_number": "404-289-0314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4229 Snapfinger Woods Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300353440",
            "country_code": "US",
            "telephone_number": "404-286-9252",
            "fax_number": "404-286-9253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "REGINALD",
        "middle_name": "B",
        "credential": "CPS-AD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.