Kathy Lynn McKenzie, NP
Individual provider Active NPI Family Nurse Practitioner · Bolton, NC
NPI 1356967368 · NPPES record last updated Oct 28, 2021
Key facts
- NPI
- 1356967368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5013233 (NC)
- Practice address
- 213 9TH St
Bolton, NC 28423-8410 - Phone
- (910) 212-6918
- Fax
- (910) 320-8418
- NPI assigned
- Jun 25, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of South Alabama College of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Goshen Medical Center Incorporated
Practice addresses (Care Compare)
270 N US Hwy 701 Byp
Tabor City, NC 28463-8378
Phone (910) 653-1901
Hospital & facility affiliations
- Well Care Home Health
- Columbus Regional Healthcare System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201013001735 | NC | Practitioner - Nurse Practitioner | 6507286507 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5013233 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goshen Medical Center Incorporated | Current | Accepting new patients | |
| Goshen Medical Center Incorporated | Current |
Accepting new patients | |
| Goshen Medical Center Incorporated | Current |
Accepting new patients | |
| Goshen Medical Center, Incorporated | Current | Accepting new patients | |
| Goshen Medical Center Incorporated | Past | Accepting new patients | |
| Goshen Medical Center Incorporated | Past | Accepting new patients |
Locations
213 9th St
Bolton, NC 28423
Phone (910) 212-6918
444 SW Center St
Faison, NC 28341
Phone (910) 267-0421
270 N US Highway 701 Byp
Tabor City, NC 28463
Phone (706) 830-0277
Interoperability endpoints
- kmckenzie@goshenmedical.cloudcraftdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5013233 | NC | Yes |
Addresses
Primary practice location
213 9TH St
Bolton, NC 28423-8410
Mailing address
213 9TH St
Bolton, NC 28423-8410
Phone (910) 212-6918
Other providers in Bolton, NC
- D&a Family Care Home LLC
- Elite Care of NC, LLC
- Goshen Medical Center Incorporated
- Kelly Barnes Laham
- Kimberly Anne Major
- Lauren McPherson
- Velma G Patrick
- Ronnette Smith
- Chelsea Leah Stubbings
All providers in Bolton, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.