Wayland W McKenzie MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

19760 Issued in NC

Legal business name

WAYLAND W MCKENZIE MD PA

Practice address

500 Banner Ave Ste a
Greensboro, NC 27401-3284

Phone

(336) 273-8638

Fax

(336) 274-0146

NPI assigned

Aug 6, 2009

Organization subpart

No

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

Authorized official

Name

Wayland Wilson McKenzie Sr., M.D.

Title

President/Owner

Phone

(336) 273-8638

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1285865329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BANNER AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274013284",
            "telephone_number": "336-273-8638",
            "fax_number": "336-274-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BANNER AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274013284",
            "telephone_number": "336-273-8638",
            "fax_number": "336-274-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYLAND W MCKENZIE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "WAYLAND",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "336-273-8638",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "19760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8957131",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; 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.