Individual provider Active NPI

McKenzie Smith, PA-C

  • Physician Assistant
  • Draper, UT
National Provider Identifier
1265124788
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13224943-1206 Issued in UT
Practice address
1126 E 12300 S
Draper, UT 84020-9095
Phone
(801) 545-0500
Fax
(801) 545-0626
NPI assigned
May 23, 2023
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13224943-1206 UT Primary

Addresses

Primary practice location

1126 E 12300 S
Draper, UT 84020-9095

Mailing address

10433 S Redwood Rd Ste 2
South Jordan, UT 84095-8502
Phone (801) 260-1919

Other practice location 1

10433 S Redwood Rd
South Jordan, UT 84095-8502
Phone (801) 609-9798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814000113 UT Practitioner - Physician Assistant 3870955594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
After Hours Medical LLCGroup PAC ID 8123926904, 30 clinicians

Practice addresses (Care Compare)

1126 E Draper Pkwy
Draper, UT 84020-9095
Phone (801) 545-0600

3934 S 2300
Suite D
Salt Lake City, UT 84124-2848
Phone (801) 849-8500

7998 S 1300
Sandy, UT 84094-0744
Phone (801) 255-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Jul 2, 2023 Accepting new patients
After Hours Medical LLC Past Accepting new patients

Locations

476 N 900 W
Ste C
American Fork, UT 84003
Phone (801) 492-1611

10433 S Redwood Rd
South Jordan, UT 84095
Phone (801) 260-1919

10433 S Redwood Rd
#2
South Jordan, UT 84095
Phone (801) 260-1919

Interoperability endpoints

  • Direct secure messaging: afterhoursmedical.mckenziesmith@154036.advancedmd-direct.com

Organizations & group practices 3

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": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1265124788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10433 S REDWOOD RD STE 2",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958502",
            "telephone_number": "801-260-1919",
            "fax_number": "801-260-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 E 12300 S",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209095",
            "telephone_number": "801-545-0500",
            "fax_number": "801-545-0626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10433 S Redwood Rd",
            "address_purpose": "LOCATION",
            "city": "South Jordan",
            "state": "UT",
            "postal_code": "840958502",
            "country_code": "US",
            "telephone_number": "801-609-9798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MCKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13224943-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.