Evan McKenzie, PA-C

Individual provider Active NPI Physician Assistant · East Ridge, TN

NPI 1336075753 · NPPES record last updated Jun 23, 2026

Key facts

NPI
1336075753
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
7103 (TN)
Practice address
403 McBrien Rd
East Ridge, TN 37412-3223
Phone
(423) 894-3589
NPI assigned
Jun 23, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7103 TN Yes

Addresses

Primary practice location

403 McBrien Rd
East Ridge, TN 37412-3223

Mailing address

654 Mariner Way
Chattanooga, TN 37402-2924
Phone (423) 991-0316

Other providers in East Ridge, TN

All providers in East Ridge, TN · Physician Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.