Mackenzie Box

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

0024186498 Issued in VA

Practice address

1830 Town Center Dr Ste 205
Reston, VA 20190-3236

Phone

(703) 435-3636

NPI assigned

Feb 1, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101

  TN

  Medicare reassignment NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD (past)
• Pediatric Specialists of Virginia, LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1699119818
  NPD (past)

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1285330183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 GATEWAY DR APT 5233",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305077",
            "telephone_number": "731-267-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 TOWN CENTER DR STE 205",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903236",
            "telephone_number": "703-435-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOX",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024186498",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001317538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Anne Hartman Bowen, MSW, LCSW
• Michael G Bowers, DO
• Tonya Patrice Bowers
• Bowman and Associates LLC
• Daniel Bowman, LCSW
• Lucas Boyce
• Michael S Bradish, MD
• Ariana Braganza, AUD
• Jane Bramson, DPT
• John Douglas Bramwell, DDS

• All providers in Reston, VA
• Pediatric Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.