McKenzie Carter Kennington

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11930257-1206 Issued in UT

Practice address

5704 S 950 E
South Ogden, UT 84405-4983

Phone

(801) 791-6819

NPI assigned

Jun 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mckenzie.kennington.p1@direct.tannerclinic.nextgenshare.com

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.

• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355

  Multi-Specialty, UT

  Medicare reassignment Care Compare group NPD (past)
• Tanner Memorial Clinic

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD
• Tanner Memorial Clinic

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1710667282
  NPD
• Rosenberg Cooley Metcalf LC

  • Orthopaedic Surgery Physician
  • Park City, UT
  • NPI 1649374216

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1336764323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5704 S 950 E",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844054983",
            "telephone_number": "801-791-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNINGTON",
        "first_name": "MCKENZIE",
        "middle_name": "CARTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11930257-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Merlin Judkins, O.D.
• Miranda R Kamalu, RBT
• Julie Karlinsey
• Matthew Kavoukas, RBT
• Randi Kendell, LMT
• Alexander Warren King, PHARMD
• Carrie King
• Jonathan Andrew King, OD
• Nadya King, RBT
• Kaitlin Kwiatkowksi, RBT

• Physician Assistant in South Ogden, UT
• Providers in South Ogden, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.
• 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.