Antronette Laura McKenzie, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13312 Issued in MS

Practice address

75 Physicians LN
Southaven, MS 38671-6102

Phone

(662) 393-7722

Fax

(662) 393-7756

NPI assigned

Jul 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Desoto Family Medical Center

  • Family Medicine Physician
  • Southaven, MS
  • NPI 1528150398
  Medicare reassignment NPD
• Advanced Primary Care LLC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1033249974
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1336146315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PHYSICIANS LN",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716102",
            "telephone_number": "662-393-7722",
            "fax_number": "662-393-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PHYSICIANS LN",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716102",
            "telephone_number": "662-393-7722",
            "fax_number": "662-393-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ANTRONETTE",
        "middle_name": "LAURA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "13312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica McGarrity, DPT
• Trevor McGee
• Casey B McGhee, P.T.
• Karolyn McGhee
• Katelyn McGrath, MSW
• Carrie E McKiernon, CFNP
• Brittany Leafaye McKinney, LCSW
• Michael McKnatt
• Emma McLearen, COTA/L
• Taylor Delaney McMahon

• Family Medicine Physician in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.