Individual provider Active NPI

McKenzie Millner, RDN

  • Metabolic Nutrition Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1366059834
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Practice address
4530 E Muirwood Dr Ste 111
Phoenix, AZ 85048-7693
Phone
(480) 961-2365
Fax
(480) 961-2382
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X Primary

Addresses

Primary practice location

4530 E Muirwood Dr Ste 111
Phoenix, AZ 85048-7693

Mailing address

4530 E Muirwood Dr Ste 111
Phoenix, AZ 85048-7693
Phone (480) 961-2365

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Athena Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1366059834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E MUIRWOOD DR STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487693",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLNER",
        "first_name": "MCKENZIE",
        "name_prefix": "Ms.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Athena",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Athena",
            "address_1": "4530 E Muirwood Dr Ste 111",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850487693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.