NPIMap

Organization Active NPI

McKenzie Physician Services LLC

  • General Practice Physician
  • Brentwood, TN
National Provider Identifier
1316909054
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MCKENZIE PHYSICIAN SERVICES LLC
Practice address
1573 Mallory LN Ste 100
Brentwood, TN 37027-2895
Phone
(152) 221-1400
NPI assigned
Apr 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Laura J Fey
Title
Sr. Director Physician Rev Cycle
Phone
(615) 221-3641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X

Addresses

Primary practice location

1573 Mallory LN Ste 100
Brentwood, TN 37027-2895

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7000

Other identifiers 1

IdentifierTypeStateIssuer
269509MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040903000766 OR Part B Supplier - Clinic/Group Practice 1254307994 Receives reassigned benefits from 227 practitioners
Practice locations: Coos Bay, OR; Springfield, OR; Florence, OR; Eugene, OR

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2555 NE Belvue St
Corvallis, OR 97330
Phone (541) 768-2220

705 9th St
Ste 4
Florence, OR 97439
Phone (541) 744-8613

4480 Highway 101
Bldg C
Florence, OR 97439

4480 Highway 101
Bldg G
Florence, OR 97439
Phone (541) 997-2319

4480 Highway 101
Ste A
Florence, OR 97439

960 N 16th St
Ste 200
Springfield, OR 97477
Phone (541) 228-3330

960 N 16th St
Ste 100
Springfield, OR 97477
Phone (541) 744-6172

960 16th St
Ste 108N
Springfield, OR 97477

960 N 16th St
Ste 208
Springfield, OR 97477
Phone (541) 744-6130

960 N 16th St
Ste 104
Springfield, OR 97477
Phone (541) 744-8660

960 N 16th St
Ste 16
Springfield, OR 97477
Phone (541) 744-6172

960 N 16th St
Ste 206
Springfield, OR 97477
Phone (541) 744-6130

Practitioners & affiliated clinicians

Practitioners 261

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 261

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1316909054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7000",
            "fax_number": "615-465-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 MALLORY LN STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272895",
            "telephone_number": "152-221-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269509",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.