Mackenzie Gorman, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

53-81287-052 Issued in KS

Practice address

11124 E 28TH St N Ste 103
Wichita, KS 67226-4562

Phone

(316) 789-3192

NPI assigned

Jul 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Wichita Urology Group P.a.

  • Urology Physician
  • Wichita, KS
  • NPI 1639157498
  Medicare reassignment
• Kansas Spine Anesthesia Corporation PA

  • Pain Medicine (Anesthesiology) Physician
  • Wichita, KS
  • NPI 1720345911
  NPD (past)

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1346976941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 E 28TH ST N STE 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264562",
            "telephone_number": "316-789-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11124 E 28TH ST N STE 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264562",
            "telephone_number": "316-789-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "MACKENZIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-81287-052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": ".",
            "affiliation": "N",
            "endpointDescription": "NONE - N/A",
            "address_1": "11124 E 28th St N Ste 103",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672264562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael D Gordon, OD
• Lori Gore
• Nicholas J Gorges
• Donna Marie Gorman, LCMFT, LCAC
• Jacqueline A Gorman, PA-C
• Yahya H Goronga, CRNA
• Christa Gosnell, LMSW
• Corbin Gosnell
• Diane K Gossen, LSCSW
• Chelsey Gotti

• Family Nurse Practitioner in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.