Active NPI
Jason D McKenzie, APRN, FNP-C
- Family Nurse Practitioner
- Owingsville, KY
National Provider Identifier
1265709497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3012593
- Practice address
- 42 Treadway Drive
Owingsville, KY 40360 - Phone
- (606) 674-6396
- NPI assigned
- Nov 16, 2011
- Last updated
- Oct 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3012593 | KY | Primary |
Addresses
Primary practice location
42 Treadway Drive
Owingsville, KY 40360
Mailing address
330 Hilltop Est
Morehead, KY 40351-9258
Phone (606) 356-5689
Other practice location 1
222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6211 ext. 6211
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100580860 | Medicaid | KY | |
| 1113790 | Other | KY | RN |
| 3012593 | Other | KY | APRN |
| F07180892 | Other | KY | AANP NATIONAL CERT. |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1751 | KY | MD | Massage Therapist |
| 3012593 | KY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570665600000",
"number": "1265709497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 HILLTOP EST",
"city": "MOREHEAD",
"state": "KY",
"postal_code": "403519258",
"telephone_number": "606-356-5689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 TREADWAY DRIVE",
"city": "OWINGSVILLE",
"state": "KY",
"postal_code": "40360",
"telephone_number": "606-674-6396"
}
],
"practiceLocations": [
{
"address_1": "222 Medical Cir",
"address_purpose": "LOCATION",
"city": "Morehead",
"state": "KY",
"postal_code": "40351",
"country_code": "US",
"telephone_number": "606-783-6211 x6211",
"fax_number": "606-783-6711",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENZIE",
"first_name": "JASON",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-16",
"last_updated": "2019-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3012593",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100580860",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "1113790",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APRN",
"identifier": "3012593",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AANP NATIONAL CERT.",
"identifier": "F07180892",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Owingsville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.