Active NPI
Mackenzie Brown LLC
- Sports Physical Therapist
- Haiku, HI
National Provider Identifier
1255869707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- Legal business name
- MACKENZIE BROWN LLC
- Practice address
- 810 Kokomo Rd Ste 159
Haiku, HI 96708-5081 - Phone
- (804) 822-2262
- Fax
- (808) 442-1421
- NPI assigned
- May 29, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mackenzie A Brown, DPT
- Title
- Owner, Physical Therapist
- Phone
- (808) 757-5724
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | HI | Primary | |
| Orthopedic Physical Therapist | 2251X0800X |
Addresses
Primary practice location
810 Kokomo Rd Ste 159
Haiku, HI 96708-5081
Mailing address
PO Box 811
Makawao, HI 96768-0811
Phone (808) 757-5724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180619002415 | HI | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5799030573 |
Receives reassigned benefits from 6 practitioners Practice locations: Haiku, HI |
National Provider Directory
National Provider DirectoryLocations
810 Kokomo Rd
Ste 159
Haiku, HI 96708
Phone (808) 214-8224
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1522886400000",
"number": "1255869707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 811",
"city": "MAKAWAO",
"state": "HI",
"postal_code": "967680811",
"telephone_number": "808-757-5724",
"fax_number": "808-442-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 KOKOMO RD STE 159",
"city": "HAIKU",
"state": "HI",
"postal_code": "967085081",
"telephone_number": "804-822-2262",
"fax_number": "808-442-1421"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MACKENZIE BROWN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-29",
"last_updated": "2018-04-05",
"status": "A",
"authorized_official_last_name": "BROWN",
"authorized_official_first_name": "MACKENZIE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
"authorized_official_telephone_number": "808-757-5724",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPT"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Sports",
"state": "HI",
"license": null,
"primary": true
},
{
"code": "2251X0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haiku, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.