Individual provider Active NPI

Mackenzie Lock, CRNA

  • Certified Registered Nurse Anesthetist
  • Wichita, KS
National Provider Identifier
1295318905
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
138572 Issued in KS
Practice address
8080 E Central Ave Ste 250
Wichita, KS 67206-2367
Phone
(316) 686-7327
Fax
(316) 686-1557
NPI assigned
Apr 30, 2021
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 138572 KS Primary

Addresses

Primary practice location

8080 E Central Ave Ste 250
Wichita, KS 67206-2367

Mailing address

8080 E Central Ave Ste 250
Wichita, KS 67206-2367
Phone (316) 686-7327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210623002808 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092116459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wichita Anesthesiology CharteredGroup PAC ID 4587577796, 68 clinicians

Practice addresses (Care Compare)

8080 E Central Ave
Suite 250
Wichita, KS 67206-2367
Phone 3166867327202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
40.05 of 100Reported as group
Quality
47.12
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
138572KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 9, 2023 Accepting new patients

Locations

1124 W 21st St
#100
Andover, KS 67002
Phone (316) 440-3200

8080 E Central Ave
Ste 250
Wichita, KS 67206
Phone (316) 686-1564

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1295318905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 E CENTRAL AVE STE 250",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062367",
            "telephone_number": "316-686-7327",
            "fax_number": "316-686-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 E CENTRAL AVE STE 250",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062367",
            "telephone_number": "316-686-7327",
            "fax_number": "316-686-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCK",
        "first_name": "MACKENZIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "138572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.